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General NPI Number Information
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NPI Number | 1932253770
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Entity Type | Organization
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Legal Business Name | SANTIAGO R. VARELA
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 07/02/2008
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Provider Practice Location Address
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Address Line | 260 CALLE COLON
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City | AGUADA
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State | PR
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Zip | 00602-2925
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Country | US
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Telephone | 787-868-3710
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Fax | 787-868-2940
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Provider Business Mailing Address
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Address Line | 260 CALLE COLON
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City | AGUADA
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State | PR
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Zip | 00602-2925
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Country | US
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Telephone | 787-868-3710
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Fax | 787-868-2940
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Authorized Official
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Title or Position | OWNER
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Name | MRS. GLADYS AGRONT
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Credential |
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Telephone | 787-868-3710
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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 | 07-F-1293
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License Number State | PR
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