=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861527632
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARIA A MOYA PHARMACY TECHNICIAN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/22/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | MUNOZ RIVERA #19 FARM LA MONSERRATE
-----------------------------------------------------
City | SALINAS
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00757
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-824-2220
-----------------------------------------------------
Fax | 787-824-5617
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1595
-----------------------------------------------------
City | STA ISABEL
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00757
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 707-202-0067
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183700000X
-----------------------------------------------------
Taxonomy Name | Pharmacy Technician
-----------------------------------------------------
License Number | 5030
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------