MEDICARE: AUREA E SANTIAGO RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	3809	PR
2	183500000X	Pharmacist	28RI02878300	NJ

General Provider Information

NPI Number	:	1003101254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUREA E SANTIAGO RPH

Provider Business Mailing Address
First Line	:	COND. ATRIUM PARK 17 C CALLE REGINA MEDINA
Second Line	:	APARTAMENTO A303
City	:	GUAYNABO
State	:	PR
Zip	:	00969
Country	:	US
Telephone Number	:	787-529-1821
Fax Number	:	787-287-0558

Provider Business Practice Location Address
First Line	:	COND ATRIUM PARK # A303
Second Line	:
City	:	GUAYNABO
State	:	PR
Zip	:	00969-6001
Country	:	US
Telephone Number	:	787-529-1821
Fax Number	:	787-287-0558

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2011
Last Update Date	:	06/16/2011

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Directions to “ AUREA E SANTIAGO RPH” Practice Location

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