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General NPI Number Information
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NPI Number | 1891841680
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Entity Type | Organization
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Legal Business Name | COLON TAVAREZ PHARMACY SERVICES, INC
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | AVENIDA MONSERRATE AL1 URBANIZACION VILLA FONTANA
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City | CAROLINA
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State | PR
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Zip | 00983
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Country | US
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Telephone | 787-276-0455
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Fax | 787-752-2562
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Provider Business Mailing Address
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Address Line | PO BOX 6017
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City | CAROLINA
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State | PR
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Zip | 00984-6017
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Country | US
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Telephone | 787-276-0455
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Fax | 787-752-2562
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Authorized Official
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Title or Position | VP
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Name | MR. LUIS G COLON
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Credential | RPH
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Telephone | 787-276-0455
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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 | 07F1317
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License Number State | PR
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