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General NPI Number Information
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NPI Number | 1699947614
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Entity Type | Organization
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Legal Business Name | FARMACIA SAGRADO CORAZON EXPRESS
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Dates
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Enumeration Date | 03/31/2008
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Last Update Date | 01/31/2018
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Provider Practice Location Address
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Address Line | ED DORA PAGANELLI LOCAL 2 AVE VICENTE QUILINCHINI
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City | SABANA GRANDE
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State | PR
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Zip | 00637
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Country | US
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Telephone | 787-873-7676
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Fax | 787-873-7373
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Provider Business Mailing Address
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Address Line | URB SANTA MARIA 139 CALLE PEDRO DE ACOSTA
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City | SABANA GRANDE
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State | PR
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Zip | 00637
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Country | US
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Telephone | 787-873-1182
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Fax | 787-873-1182
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Authorized Official
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Title or Position | PIC
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Name | ILIANETTE MIRANDA
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Credential | RPH
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Telephone | 787-873-7676
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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 | 20F3348
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License Number State | PR
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