1104220250 NPI number — MRS. ALERYS YAMILKA ABREU CRUZ SR. PHARMACY TECH

Table of content: MRS. ALERYS YAMILKA ABREU CRUZ SR. PHARMACY TECH (NPI 1104220250)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104220250 NPI number — MRS. ALERYS YAMILKA ABREU CRUZ SR. PHARMACY TECH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ABREU CRUZ
Provider First Name:
ALERYS
Provider Middle Name:
YAMILKA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
SR.
Provider Credential Text:
PHARMACY TECH
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1104220250
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/17/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 760
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MAUNABO
Provider Business Mailing Address State Name:
PUERTO RICO
Provider Business Mailing Address Postal Code:
00707
Provider Business Mailing Address Country Code:
UM
Provider Business Mailing Address Telephone Number:
939-329-7081
Provider Business Mailing Address Fax Number:
939-329-7082

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
24 CALLE MUNOZ RIVERA
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MAUNABO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00707-2148
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-640-6307
Provider Business Practice Location Address Fax Number:
939-329-7082
Provider Enumeration Date:
10/17/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183700000X , with the licence number:  7414 , 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)