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General NPI Number Information
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NPI Number | 1801080163
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Entity Type | Organization
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Legal Business Name | FARMACIA RODRIQUEZ
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Dates
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Enumeration Date | 08/30/2007
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Last Update Date | 08/30/2007
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Provider Practice Location Address
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Address Line | 41 CALLE BOU
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City | COROZAL
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State | PR
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Zip | 00783-1949
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Country | US
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Telephone | 787-859-2415
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Fax | 787-859-1478
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Provider Business Mailing Address
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Address Line | PO BOX 98
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City | COROZAL
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State | PR
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Zip | 00783-0098
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER AND PHARMACIST
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Name | GRACIANY RODRIGUEZ
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Credential |
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Telephone | 787-859-2415
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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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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 096F0064
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License Number State | PR
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