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General NPI Number Information
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NPI Number | 1790796365
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Entity Type | Organization
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Legal Business Name | KIRIE ENTERPRISE INC
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 04/06/2016
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Provider Practice Location Address
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Address Line | CARR 848 KM 4.2 PLAZA 66 BO. SAN ANTON
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City | CAROLINA
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State | PR
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Zip | 00983
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Country | US
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Telephone | 787-768-4366
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Fax | 787-768-4367
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Provider Business Mailing Address
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Address Line | PO BOX 29775
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City | SAN JUAN
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State | PR
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Zip | 00929-0775
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Country | US
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Telephone | 787-768-4366
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Fax | 787-768-4367
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Authorized Official
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Title or Position | OWNER
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Name | RAFAEL RODRIGUEZ
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Credential |
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Telephone | 787-768-4366
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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 | 18F2367
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License Number State | PR
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