Organization
LDCA ENTERPRISE INC
Active
Other names
CIV Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS VILLAHERMOSA CPC , PMB (PRESIDENT)
(787) 374-7467
Entity
Organization
Contact information
Practice address
CARR 125 KM 21.9 BO. BAHOMAMEY, SAN SEBASTIAN MEDICAL CENTER SUITE # 4, SAN SEBASTIAN, PR 00685
(787) 926-7999
(787) 926-7899
Mailing address
PO BOX 902, SAN SEBASTIAN, PR 00685-0902
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
16-F-3080
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2138233
PK
—
Enumeration date
12/19/2012
Last updated
08/06/2015
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