# HIS PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** HIS Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376093401
- **Authorized official:** CORALYS MORALES (PRESIDENT)
- **Authorized official phone:** (939) 717-5670

## Contact information

- **Practice address:** EDIFICIO PUGNADO CARR. 137 KM 7.2, LOCAL 2 BO. PUGNADO, VEGA BAJA, PR 00693-0000
- **Practice address phone:** (787) 965-7999
- **Practice address fax:** (787) 965-7998
- **Mailing address:** PASEO LOS CORALES II, 766 CALLE MAR DEL NORTE, DORADO, PR 00646-0000
- **Mailing address phone:** (939) 717-5670

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 18-F-3403 | PR | Yes |
| 3336S0011X | Specialty Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 10/13/2016
- **Last updated:** 04/20/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2164661 | PK | — |