Organization
NOVA PHARMACY INC
Active
Other names
NOVA PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
GERARDO RIVERA (OWNER)
(787) 375-0295
Entity
Organization
Contact information
Practice address
URB LA HACIENDA CALLE 1 A-1 BO JAUCA, SANTA ISABEL, PR 00757
(787) 845-0505
(787) 845-0505
Mailing address
PO BOX 1050, SALINAS, PR 00751-1050
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1722
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4028230
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
09/12/2012
Last updated
09/12/2012
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