MEDICARE: MISS LIZ MARIE GARCES ORTIZ PHARM.D, 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	6441	PR

General Provider Information

NPI Number	:	1275065799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS LIZ MARIE GARCES ORTIZ PHARM.D, RPH

Provider Business Mailing Address
First Line	:	CARR 167 AVE LAS CUMBRES PLAZA MAYOR
Second Line	:	FARMACIA KMART 7788 - REXVILLE TOWN CENTER
City	:	BAYAMON
State	:	PR
Zip	:	00956-9212
Country	:	US
Telephone Number	:	787-730-2615
Fax Number	:

Provider Business Practice Location Address
First Line	:	CARR.167 AVE.LAS CUMBRES PLAZA MAYOR
Second Line	:	KMART PHARMACY 7788 - REXVILLE TOWN CENTER
City	:	BAYAMON
State	:	PR
Zip	:	00956-9212
Country	:	US
Telephone Number	:	787-730-2615
Fax Number	:

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

Provider Enumeration Date	:	04/03/2017
Last Update Date	:	04/03/2017

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