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General NPI Number Information
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NPI Number | 1710290077
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Entity Type | Organization
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Legal Business Name | FARMACIA JESIAH INC.
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Dates
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Enumeration Date | 07/15/2010
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Last Update Date | 07/15/2010
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Provider Practice Location Address
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Address Line | STREET E L11 VISTA DEL PALMAR
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City | YAUCO
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State | PR
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Zip | 00698
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Country | US
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Telephone | 787-463-3023
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Fax |
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Provider Business Mailing Address
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Address Line | STREET E L11 VISTA DEL PALMAR
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City | YAUCO
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State | PR
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Zip | 00698
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Country | US
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Telephone | 787-463-3023
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Fax |
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Authorized Official
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Title or Position | PHARMACY TECHNICIAN
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Name | MR. HERIBERTO VAZQUEZ
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Credential |
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Telephone | 787-463-3023
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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 | PR
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