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NPI 1043620123

OrganizationActive

Own Bussiness

NPI 1043620123 · Managed Care Organization Pharmacy · Ponce, PR

Provider details

NPI number: 1043620123
Entity type: Organization
Primary specialty: Managed Care Organization PharmacySuppliers
Authorized official: Brenda Gonzalez, Pharmacy Technician

Practice location

1933 Calle Guayabo

Los Caobos

Ponce, PR 00716

Phone: (787) 365-8662

More PR providers

Mailing address

1933 Calle Guayabo

Ponce, PR 00716

Registry dates

Enumerated: 2014-04-29
Last updated: 2014-04-29

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Own Bussiness — NPI 1043620123, Ponce, PR | NPI Central