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Organization
HIS PHARMACY LLC
Active
Organization
HIS PHARMACY LLC
Active
Other names
HIS Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CORALYS MORALES (PRESIDENT)
(939) 717-5670
Entity
Organization
Contact information
Practice address
EDIFICIO PUGNADO CARR. 137 KM 7.2, LOCAL 2 BO. PUGNADO, VEGA BAJA, PR 00693-0000
(787) 965-7999
(787) 965-7998
Mailing address
PASEO LOS CORALES II, 766 CALLE MAR DEL NORTE, DORADO, PR 00646-0000
(939) 717-5670
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
18-F-3403
PR
3336S0011X
Specialty Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2164661
PK
—
Enumeration date
10/13/2016
Last updated
04/20/2017
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