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General NPI Number Information
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NPI Number | 1598847436
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Entity Type | Organization
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Legal Business Name | PAN AMERICAN PHARMACY
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 232 60TH ST
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City | WEST NEW YORK
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State | NJ
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Zip | 07093-2824
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Country | US
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Telephone | 201-861-7966
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Fax | 201-868-7945
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Provider Business Mailing Address
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Address Line | 232 60TH ST
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City | WEST NEW YORK
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State | NJ
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Zip | 07093-2824
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Country | US
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Telephone | 201-861-7966
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Fax | 201-868-7945
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | MR. FERNANDO IGNACIO ESTREMS
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Credential | R.PH.
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Telephone | 201-861-7966
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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 | 28RS00627800
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License Number State | NJ
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