Organization
AIZA Y PEREZ CABAN
Active
Other names
FARMACIA LA 110
Organization subpart
No
Provider details
NPI number
Authorized official
AIZA PEREZ (OWNER)
(787) 877-0110
Entity
Organization
Contact information
Practice address
CARR 110 KM 13 PT 0, BO PUEBLO, MOCA, PR 00676
(787) 877-0110
(787) 818-0110
Mailing address
PO BOX 57, MOCA, PR 00676-0057
(787) 877-0110
(787) 818-0110
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
17F2076
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
17-F-2076
—
PR
01
—
2087130
PK
—
Enumeration date
11/20/2006
Last updated
02/28/2017
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