# OWN BUSSINESS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043620123
- **Authorized official:** BRENDA LEE GONZALEZ (PHARMACY TECHNICIAN)
- **Authorized official phone:** (787) 365-8662

## Contact information

- **Practice address:** 1933 CALLE GUAYABO, LOS CAOBOS, PONCE, PR 00716
- **Practice address phone:** (787) 365-8662
- **Mailing address:** 1933 CALLE GUAYABO, LOS CAOBOS, PONCE, PR 00716
- **Mailing address phone:** (787) 365-8662

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336M0003X | Managed Care Organization Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 04/29/2014
- **Last updated:** 04/29/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 132035 | REGISTER AND CERTIFICATION NUMBER (ACTIVE ) | PR |