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General NPI Number Information
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NPI Number | 1598817595
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Entity Type | Organization
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Legal Business Name | NACHESCA CARABELLO
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 07/15/2008
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Provider Practice Location Address
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Address Line | LOCAL C31C CONSOLIDATED MALL
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City | CAGUAS
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State | PR
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Zip | 00726
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Country | US
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Telephone | 787-286-1694
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Fax | 787-316-8737
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Provider Business Mailing Address
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Address Line | PMB 194 HC01 BOX 29030
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City | CAGUAS
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State | PR
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Zip | 00725
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NACHESCA CARABALLO
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Credential |
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Telephone | 787-286-1694
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 08F2457
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License Number State | PR
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