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General NPI Number Information
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NPI Number | 1518067172
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Entity Type | Organization
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Legal Business Name | FARMACIA COMANDANTE LLC
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Dates
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Enumeration Date | 09/24/2006
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Last Update Date | 06/23/2014
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Provider Practice Location Address
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Address Line | 932 CALLE CARMEN HERNANDEZ URBANIZACION EL COMANDANTE
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City | SAN JUAN
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State | PR
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Zip | 00924-3518
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Country | US
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Telephone | 787-752-0315
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Fax | 787-257-7940
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Provider Business Mailing Address
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Address Line | 932 CALLE CARMEN HERNANDEZ URBANIZACION EL COMANDANTE
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City | SAN JUAN
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State | PR
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Zip | 00924-3518
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Country | US
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Telephone | 787-752-0315
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Fax | 787-257-7940
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. PEDRO NIEVES
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Credential | LICENCIADO
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Telephone | 787-752-0315
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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 | 07-F-0638
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License Number State | PR
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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 |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 16-F-3198
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License Number State | PR
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