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General NPI Number Information
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NPI Number | 1982755872
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Entity Type | Organization
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Legal Business Name | FARMACIA LASALLE NIEVES INC
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | CARR 113 KM 11.6 CACAO WARD
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City | QUEBRADILLAS
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State | PR
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Zip | 00678-2621
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Country | US
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Telephone | 787-895-1001
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Fax | 787-895-1882
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Provider Business Mailing Address
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Address Line | PO BOX 976
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City | QUEBRADILLAS
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State | PR
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Zip | 00678-0976
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Country | US
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Telephone | 787-895-1001
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Fax | 787-895-1882
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Authorized Official
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Title or Position | OWNER
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Name | MRS. DIANA NIEVES-CURBELO
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Credential | PH
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Telephone | 787-895-1001
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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-1207
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License Number State | PR
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