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General NPI Number Information
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NPI Number | 1841344942
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Entity Type | Organization
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Legal Business Name | FARMACIA SAN ANTONIO
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 07/13/2007
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Provider Practice Location Address
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Address Line | 108 CALLE GEORGETTI
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City | NARANJITO
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State | PR
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Zip | 00719-3011
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Country | US
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Telephone | 787-869-2190
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Fax | 787-869-6026
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Provider Business Mailing Address
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Address Line | PO BOX 449
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City | NARANJITO
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State | PR
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Zip | 00719-0449
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Country | US
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Telephone | 787-869-2190
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Fax | 787-869-6026
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Authorized Official
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Title or Position | OWNER
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Name | MR. LUIS A MORALES
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Credential |
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Telephone | 787-869-2190
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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-0141
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License Number State | PR
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