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General NPI Number Information
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NPI Number | 1548397011
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Entity Type | Organization
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Legal Business Name | NUESTRA FARMACIA Y COLMADO ALTURAS INC
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 04/27/2016
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Provider Practice Location Address
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Address Line | CALLE A ESQUINA CALLE C BLOQUE A-5 URB. ALTURAS
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City | VEGA BAJA
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State | PR
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Zip | 00693-6421
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Country | US
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Telephone | 787-855-3713
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Fax | 939-697-6116
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Provider Business Mailing Address
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Address Line | CALLE A ESQUINA CALLE C BLOQUE A-5 URB. ALTURAS
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City | VEGA BAJA
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State | PR
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Zip | 00693-6421
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Country | US
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Telephone | 787-855-3713
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Fax | 939-697-6116
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSE CARDONA
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Credential |
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Telephone | 787-855-3713
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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 | 18-F-3015
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License Number State | PR
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