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General NPI Number Information
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NPI Number | 1851624829
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Entity Type | Organization
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Legal Business Name | DESARROLLADORA COMERCIAL INC
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Dates
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Enumeration Date | 09/09/2009
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Last Update Date | 09/09/2009
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Provider Practice Location Address
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Address Line | 233 CALLE SANTA ANA # A BO COCO NUEVO
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City | SALINAS
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State | PR
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Zip | 00751-2625
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Country | US
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Telephone | 787-824-2617
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Fax | 787-824-6797
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Provider Business Mailing Address
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Address Line | PO BOX 1
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City | AGUIRRE
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State | PR
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Zip | 00704-0001
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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 | PRESIDENT
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Name | MARILIANA BENNAZAR
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Credential |
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Telephone | 787-444-2365
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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 | 11-F-2747
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License Number State | PR
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