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General NPI Number Information
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NPI Number | 1821373366
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Entity Type | Organization
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Legal Business Name | FARMACIA MI BUEN VECINO
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Dates
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Enumeration Date | 10/17/2011
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Last Update Date | 03/27/2012
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Provider Practice Location Address
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Address Line | CARRETERA 115 KILOMETRO 26.1 BARRIO ASOMANTE
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City | AGUADA
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State | PR
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Zip | 00676
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Country | US
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Telephone | 787-877-8100
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Fax | 787-877-7050
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Provider Business Mailing Address
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Address Line | PO BOX 177
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City | MOCA
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State | PR
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Zip | 00676-0177
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Country | US
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Telephone | 787-525-7314
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Fax | 787-877-7050
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Authorized Official
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Title or Position | PHARMACIST/OWNER
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Name | JOSUE GONZALEZ
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Credential |
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Telephone | 787-525-7314
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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 | 13-F-2971
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License Number State | PR
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