=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720324957
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SHIFA PHARMACY INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/16/2012
-----------------------------------------------------
Last Update Date | 02/20/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1 CARR 695 HIGUILLAR
-----------------------------------------------------
City | DORADO
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00646-9700
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-428-5221
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 5048
-----------------------------------------------------
City | CAROLINA
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00984-5048
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-598-6543
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHARMACIST IN CHARGE
-----------------------------------------------------
Name | AMYN ZAHER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 787-598-6543
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | 14-F-3087
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------