1841361243 NPI number — PROFESSIONAL PHARMACY LA PAZ PHARMACY INC

Table of content: MS. BARBARA JOAN NORTON LCSWR (NPI 1134294903)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841361243 NPI number — PROFESSIONAL PHARMACY LA PAZ PHARMACY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PROFESSIONAL PHARMACY LA PAZ PHARMACY INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841361243
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CALLE JOSE RODRIGUEZ IRIZARRY #152
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARECIBO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00612
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-881-2440
Provider Business Mailing Address Fax Number:
787-880-3258

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR #2 KM 62.7 BO SABANA HOYOS SECTOR CANDELARIA
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARECIBO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-881-2440
Provider Business Practice Location Address Fax Number:
787-880-3258
Provider Enumeration Date:
11/10/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MONROUZEAU
Authorized Official First Name:
LUIS
Authorized Official Middle Name:
R
Authorized Official Title or Position:
OWNER PRESIDENT
Authorized Official Telephone Number:
787-878-1548

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  07F2302 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4017061 . This is a "NCPDP" identifier . This identifiers is of the category "OTHER".