MEDICARE: MRS. DENISSE MARCANO PHARMD

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	6229	PR

General Provider Information

NPI Number	:	1346616513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DENISSE MARCANO PHARMD

Provider Business Mailing Address
First Line	:	BOX 2400
Second Line	:	PMB 226
City	:	TOA BAJA
State	:	PR
Zip	:	00000-0951
Country	:	US
Telephone Number	:	787-513-6072
Fax Number	:

Provider Business Practice Location Address
First Line	:	CARRETERA #2 KM 0.7
Second Line	:
City	:	BAYAMON
State	:	PR
Zip	:	00959-0095
Country	:	US
Telephone Number	:	787-786-6306
Fax Number	:	787-966-7652

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

Provider Enumeration Date	:	08/11/2015
Last Update Date	:	01/23/2020

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