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General NPI Number Information
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NPI Number | 1841364239
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Entity Type | Organization
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Legal Business Name | AIZA Y PEREZ CABAN
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 02/28/2017
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Provider Practice Location Address
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Address Line | CARR 110 KM 13 PT 0 BO PUEBLO
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City | MOCA
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State | PR
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Zip | 00676
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Country | US
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Telephone | 787-877-0110
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Fax | 787-818-0110
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Provider Business Mailing Address
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Address Line | PO BOX 57
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City | MOCA
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State | PR
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Zip | 00676-0057
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Country | US
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Telephone | 787-877-0110
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Fax | 787-818-0110
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Authorized Official
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Title or Position | OWNER
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Name | AIZA PEREZ
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Credential |
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Telephone | 787-877-0110
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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 | 17F2076
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License Number State | PR
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