Organization
PANCHO BLU LLC DBA FARMACIAS ALIADAS GURABO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD SAEZ (PRESIDENT)
(787) 736-7100
Entity
Organization
Contact information
Practice address
RD 189 RALPH'S PLAZA, SUITE 6, GURABO, PR 00778
(787) 736-7100
(787) 736-0300
Mailing address
STREET 4 #150 URB EL PARQUE, SAN LORENZO, PR 00754
(787) 736-7100
(787) 736-0300
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
15F3115
PR
3336S0011X
Specialty Pharmacy
15F3115
PR
Other
Enumeration date
03/19/2013
Last updated
03/19/2013
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