MEDICARE: EMPRESAS BONILLA COLON INC

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	332B00000X	Durable Medical Equipment & Medical Supplies	5559900001	PR
2	3336C0003X	Community/Retail Pharmacy	19-F-2315	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4007078	OTHER	PR	NABP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336123322
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMPRESAS BONILLA COLON INC

Provider Business Mailing Address
First Line	:	PO BOX 1542
Second Line	:
City	:	VILLALBA
State	:	PR
Zip	:	00766-1542
Country	:	US
Telephone Number	:	787-847-8600
Fax Number	:	787-847-3336

Provider Business Practice Location Address
First Line	:	CARR 149 KM 56.7
Second Line	:	SECTOR TIERRA SANTA
City	:	VILLALBA
State	:	PR
Zip	:	00766-3401
Country	:	US
Telephone Number	:	787-847-8600
Fax Number	:	787-847-3336

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. IDALIA BONILLA
Credential	:
Telephone Number	:	787-847-8600

Provider Enumeration Date	:	12/02/2005
Last Update Date	:	08/28/2025

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Directions to “EMPRESAS BONILLA COLON INC ” Practice Location

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