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General NPI Number Information
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NPI Number | 1730754979
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Entity Type | Organization
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Legal Business Name | PHARMACY EXPRESS
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Dates
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Enumeration Date | 05/20/2021
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Last Update Date | 05/31/2021
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Provider Practice Location Address
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Address Line | CALLE CORCHADO FINAL CDT CANOVANAS BO. PUEBLO
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City | CANOVANAS
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State | PR
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Zip | 00729
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Country | US
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Telephone | 904-540-5303
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 162
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City | RIO GRANDE
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State | PR
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Zip | 00745-0162
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Country | US
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Telephone | 904-540-5303
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Fax |
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Authorized Official
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Title or Position | PHARMACIST/OWNER
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Name | IZETTE M. DEL MORAL
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Credential |
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Telephone | 904-540-5303
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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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