# ED S PHARMACY CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ed's Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619281599
- **Authorized official:** EDGARDO CARMONA (PHARMACY MANAGER)
- **Authorized official phone:** (787) 381-5471

## Contact information

- **Practice address:** RD 307, KM 4.8, BOQUERON, PR 00622
- **Practice address phone:** (787) 255-0485
- **Practice address fax:** (787) 255-0486
- **Mailing address:** PO BOX 1790, BOQUERON, PR 00622-1790
- **Mailing address phone:** (787) 255-0485
- **Mailing address fax:** (787) 255-0486

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 12-F-2870 | PR | Yes |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 08/03/2010
- **Last updated:** 06/20/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4027492 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |