Organization
JIREH D&M INC
Active
Other names
Jireh Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN GONZALEZ DOCTOR (PIC/DIRECTOR)
(787) 431-1285
Entity
Organization
Contact information
Practice address
BO. HATO ABAJO URB. SAN RAFAEL CARR 492 KM 5.7, ARECIBO, PR 00612
(787) 680-7778
(787) 680-7710
Mailing address
PO BOX 3155, ARECIBO, PR 00613-3155
(787) 680-7778
(787) 680-7710
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BN1400X
Nursing Facility Supplies (DME)
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
18-F-3379
PR
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2152194
PK
—
Enumeration date
05/22/2015
Last updated
07/27/2016
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