=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982997789
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SWANILDA MERCADO PHARM.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/26/2011
-----------------------------------------------------
Last Update Date | 05/26/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | EDF 477 CARR # 3 WALGREENS 00906
-----------------------------------------------------
City | HUMACAO
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00791-4620
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-852-1330
-----------------------------------------------------
Fax | 787-852-1733
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | EDF 477 CARR # 3 WALGREENS 00906
-----------------------------------------------------
City | HUMACAO
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00791
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-852-1330
-----------------------------------------------------
Fax | 787-852-1733
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 5163
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------