=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477688877
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GELPI BROTHERS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/23/2007
-----------------------------------------------------
Last Update Date | 05/29/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1015 AVE AMERICO MIRANDA REPARTO METROPOLITANO
-----------------------------------------------------
City | SAN JUAN
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00921-2804
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-767-0012
-----------------------------------------------------
Fax | 787-751-4374
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 363808
-----------------------------------------------------
City | SAN JUAN
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00936-3808
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-764-2655
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | MR. JOSE GONZALEZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 787-767-0012
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | 07F-0592
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------