# FARMACIA SAGRADO CORAZON EXPRESS

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

## Provider details

- **NPI number:** 1699947614
- **Authorized official:** ILIANETTE MIRANDA RPH (PIC)
- **Authorized official phone:** (787) 873-7676

## Contact information

- **Practice address:** ED DORA PAGANELLI LOCAL 2, AVE VICENTE QUILINCHINI, SABANA GRANDE, PR 00637
- **Practice address phone:** (787) 873-7676
- **Practice address fax:** (787) 873-7373
- **Mailing address:** URB SANTA MARIA 139, CALLE PEDRO DE ACOSTA, SABANA GRANDE, PR 00637
- **Mailing address phone:** (787) 873-1182
- **Mailing address fax:** (787) 873-1182

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 20F3348 | PR | Yes |

## Other

- **Enumeration date:** 03/31/2008
- **Last updated:** 01/31/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2087603 | PK | — |