Organization
PUEBLO INC
Active
Parent organization
PUEBLO INC
Other names
Pueblo Pharmacy 984, Pueblo Pharmacy #984
Organization subpart
Yes
Provider details
NPI number
Legal business name
PUEBLO INC
Authorized official
LUIS M MALDONADO-PENA (VP FINANCES)
(787) 757-3131
Entity
Organization
Contact information
Practice address
1511 AVE PONCE DE LEON, SAN JUAN, PR 00909
(787) 725-8112
(787) 725-8115
Mailing address
PO BOX 1967, CAROLINA, PR 00984-1967
(787) 757-3131
(787) 793-8144
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
16F3186
PR
1835G0303X
Geriatric Pharmacist
16F3186
PR
1835N1003X
Nutrition Support Pharmacist
16F3186
PR
1835P1200X
Pharmacotherapy Pharmacist
16F3186
PR
1835P1300X
Psychiatric Pharmacist
16F3186
PR
183700000X
Pharmacy Technician
16F3186
PR
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038204500
—
PR
Enumeration date
04/01/2014
Last updated
08/19/2025
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