Organization
SAN PEDRO PHARMACY CORP
Active
Other names
San Pedro Pharmacy Corp.
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA RIVERA (PRESIDENT)
(787) 404-7655
Entity
Organization
Contact information
Practice address
7 CALLE MUNOZ RIVERA, GUAYNABO, PR 00969-5705
(787) 720-2196
(787) 287-8169
Mailing address
PO BOX 296, GUAYNABO, PR 00970-0296
(787) 720-2196
(787) 287-8169
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
18F3190
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2146196
PK
—
Enumeration date
06/16/2006
Last updated
10/20/2016
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