Organization
GES CDT DR. ENRIQUE KOPPISCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAUL VILLALOBOS (PRESIDENT)
(787) 767-8758
Entity
Organization
Contact information
Practice address
404 CALLE SICILIA, ESQUINA AVE BARBOSA, SAN JUAN, PR 00923
(787) 753-6354
Mailing address
PO BOX 193044, SAN JUAN, PR 00919-3044
(787) 767-8758
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
08-F2459
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1835G0000X
PHARMACY
PR
Enumeration date
03/14/2007
Last updated
08/22/2020
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