MEDICARE: TOA ALTA PHARMACY, 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	3336C0003X	Community/Retail Pharmacy	07F2188	PR

General Provider Information

NPI Number	:	1831241512
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOA ALTA PHARMACY, INC

Provider Business Mailing Address
First Line	:	CARR 865 KM 1.3
Second Line	:	BO CAMPANILLA
City	:	TOA BAJA
State	:	PR
Zip	:	00949-5393
Country	:	US
Telephone Number	:	787-870-1434
Fax Number	:	787-870-0169

Provider Business Practice Location Address
First Line	:	CARR 865 KM 1.3
Second Line	:	BO CAMPANILLA
City	:	TOA BAJA
State	:	PR
Zip	:	00949-5393
Country	:	US
Telephone Number	:	787-870-1434
Fax Number	:	787-870-0169

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARIA S MARRERO
Credential	:
Telephone Number	:	787-870-1434

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	08/22/2020

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Directions to “TOA ALTA PHARMACY, INC ” Practice Location

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