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General NPI Number Information
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NPI Number | 1801290747
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Entity Type | Organization
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Legal Business Name | DAMAR OF PUERTO RICO SERVICES INC
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Dates
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Enumeration Date | 10/21/2014
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Last Update Date | 09/21/2015
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Provider Practice Location Address
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Address Line | CALLE FLOR ANTILLANA RES. LUIS LLORENS TORRES
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City | SANTURCE
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State | PR
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Zip | 00907
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Country | US
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Telephone | 787-982-8300
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Fax | 787-982-8300
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Provider Business Mailing Address
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Address Line | PO BOX 25130
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City | SAN JUAN
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State | PR
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Zip | 00928-5130
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Country | US
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Telephone | 787-982-8300
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Fax | 787-982-8300
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ALLAN CAO
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Credential |
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Telephone | 786-547-3240
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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 | 17-F-3155
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License Number State | PR
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