# SUPER FARMACIA NELIA

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

## Provider details

- **NPI number:** 1063430429
- **Authorized official:** DR. WALDEMAR J NIEVES (PHARMACIST)
- **Authorized official phone:** (787) 804-0131

## Contact information

- **Practice address:** 16 CALLE FRANCISCO M QUINONEZ, SABANA GRANDE, PR 00637-1945
- **Practice address phone:** (787) 873-0198
- **Practice address fax:** (787) 873-3166
- **Mailing address:** 16 CALLE FRANCISCO M QUINONEZ, SABANA GRANDE, PR 00637-1945
- **Mailing address phone:** (787) 873-0198
- **Mailing address fax:** (787) 873-3166

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 07/17/2006
- **Last updated:** 09/30/2020