1417433343 NPI number — MRS. JEDSIA N ROSARIO PHARMACY TECHNICIAN

Table of content: MRS. JEDSIA N ROSARIO PHARMACY TECHNICIAN (NPI 1417433343)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417433343 NPI number — MRS. JEDSIA N ROSARIO PHARMACY TECHNICIAN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROSARIO
Provider First Name:
JEDSIA
Provider Middle Name:
N
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PHARMACY TECHNICIAN
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:
1417433343
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/13/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
HC 69 BOX 15544
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BAYAMON
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00956-9872
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-780-7383
Provider Business Mailing Address Fax Number:
787-780-7389

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR 174 KM 10.2 SECT LA MORENITA
Provider Second Line Business Practice Location Address:
BO GUARAGUAO
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00956
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-780-7381
Provider Business Practice Location Address Fax Number:
787-780-7389
Provider Enumeration Date:
07/13/2018

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 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 11394 . This is a "STATE LICENCE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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