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General NPI Number Information
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NPI Number | 1467587550
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Entity Type | Organization
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Legal Business Name | SUPER FARMACIA NUEVA DE QUEBRADILLAS INC
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 05/08/2013
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Provider Practice Location Address
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Address Line | PLAZUELA LINERAS STE 112
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City | QUEBRADILLAS
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State | PR
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Zip | 00678
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Country | US
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Telephone | 787-895-6473
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Fax | 787-895-6473
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Provider Business Mailing Address
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Address Line | PO BOX 223
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City | QUEBRADILLAS
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State | PR
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Zip | 00678-0223
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Country | US
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Telephone | 787-895-6473
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Fax | 787-895-6473
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Authorized Official
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Title or Position | PHARMACIST
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Name | NORMA RODRIGUEZ
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Credential | PHARMACIST
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Telephone | 787-895-6473
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 14F3086
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License Number State | PR
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