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General NPI Number Information
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NPI Number | 1902945843
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Entity Type | Organization
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Legal Business Name | FARMACIA COOPERATIVA SAN MIGUEL
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 152 STREET, KM 17.8
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City | NARANJITO
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State | PR
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Zip | 00719-0459
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Country | US
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Telephone | 787-869-4710
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Fax | 787-869-1845
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Provider Business Mailing Address
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Address Line | PO BOX 459
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City | NARANJITO
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State | PR
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Zip | 00719-0459
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Country | US
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Telephone | 787-869-4710
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Fax | 787-869-1845
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Authorized Official
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Title or Position | PHARMACIST
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Name | MRS. AUREA NIEVES
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Credential |
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Telephone | 787-869-4710
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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 | 07-F-1886
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License Number State | PR
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