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General NPI Number Information
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NPI Number | 1528050192
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Entity Type | Organization
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Legal Business Name | FARMACIA DEL CONDADO, INC CSP
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Dates
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Enumeration Date | 08/18/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | H18 CALLE JOSE VILLARES CONDADO
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City | CAGUAS
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State | PR
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Zip | 00725-2463
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Country | US
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Telephone | 787-743-0001
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Fax | 787-743-0001
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Provider Business Mailing Address
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Address Line | H18 CALLE JOSE VILLARES CONDADO
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City | CAGUAS
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State | PR
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Zip | 00725-2463
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Country | US
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Telephone | 787-743-0001
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Fax | 787-743-0001
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | GLORIVETTE SENERIZ
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Credential |
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Telephone | 787-743-0001
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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 | 1184760001
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License Number State | PR
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