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General NPI Number Information
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NPI Number | 1932249265
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Entity Type | Individual
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Provider Name | MRS. RUTH JIMENEZ
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Gender | Female
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 10/19/2018
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Provider Practice Location Address
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Address Line | 15 CALLE PIMENTEL
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City | RIO GRANDE
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State | PR
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Zip | 00745-3063
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Country | US
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Telephone | 787-887-2475
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 756
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City | RIO GRANDE
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State | PR
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Zip | 00745-0756
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Country | US
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Telephone | 787-887-2475
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Fax | 787-888-1033
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 20-F-3185
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License Number State | PR
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