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General NPI Number Information
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NPI Number | 1750446092
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Entity Type | Organization
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Legal Business Name | BLANCA L. VEGA ALVARADO
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 07/23/2008
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Provider Practice Location Address
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Address Line | CARR 633 KM 4 7 BO BARAHONA
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City | MOROVIS
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State | PR
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Zip | 00687
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Country | US
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Telephone | 787-862-2244
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Fax | 787-862-2244
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Provider Business Mailing Address
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Address Line | HC 2 BOX 5778
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City | MOROVIS
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State | PR
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Zip | 00687-9721
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Country | US
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Telephone | 787-862-2244
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Fax | 787-862-2244
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Authorized Official
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Title or Position | OWNER - PHARMACIST
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Name | MRS. BLANCA VEGA
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Credential |
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Telephone | 787-862-2244
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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 | 07-F-0128
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License Number State | PR
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