# PHARMACY COSSMA YABUCOA

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

## Provider details

- **NPI number:** 1396036380
- **Authorized official:** MRS. ISOLINA MIRANDA (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (787) 739-8182

## Contact information

- **Practice address:** BARRIO JUAN MARTIN CARR 901 KM. 1.6, YABUCOA, PR 00767-0067
- **Practice address phone:** (787) 739-8182
- **Practice address fax:** (787) 893-3055
- **Mailing address:** PO BOX 1330, CIDRA, PR 00739-1330
- **Mailing address phone:** (787) 739-8182
- **Mailing address fax:** (787) 893-3055

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0002X | Clinic Pharmacy | 13F2937 | PR | — |
| 3336C0003X | Community/Retail Pharmacy | 13F2937 | PR | — |
| 3336C0004X | Compounding Pharmacy | 13F2937 | NULL | Yes |

## Other

- **Enumeration date:** 04/25/2011
- **Last updated:** 04/25/2011