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General NPI Number Information
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NPI Number | 1912229972
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Entity Type | Organization
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Legal Business Name | ETEL CORPORATION
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Dates
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Enumeration Date | 02/18/2010
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Last Update Date | 02/18/2010
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Provider Practice Location Address
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Address Line | CARR. 3 KM 4.5 PASEO DEL PRADO SHOPPING
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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 | 787-776-4300
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 29775
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City | SAN JUAN
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State | PR
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Zip | 00929
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Country | US
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Telephone | 787-776-4300
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RAFAEL A RODRIGUEZ
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Credential |
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Telephone | 787-776-4300
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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 |
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License Number State |
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