1730356767 NPI number — MARISOL CRUZ PHARMACY TECHNICIAN

Table of content: MARISOL CRUZ PHARMACY TECHNICIAN (NPI 1730356767)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730356767 NPI number — MARISOL CRUZ PHARMACY TECHNICIAN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CRUZ
Provider First Name:
MARISOL
Provider Middle Name:
Provider Name Prefix Text:
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:
1730356767
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/14/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 172
Provider Second Line Business Mailing Address:
SECTOR CATANO
Provider Business Mailing Address City Name:
CASTANER
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00631-0172
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-816-5921
Provider Business Mailing Address Fax Number:
787-816-5837

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR 651 KM 2.5 BO JUNCOS
Provider Second Line Business Practice Location Address:
ARECIBO
Provider Business Practice Location Address City Name:
ARECIBO
Provider Business Practice Location Address State Name:
PUERTO RICO
Provider Business Practice Location Address Postal Code:
00612
Provider Business Practice Location Address Country Code:
UM
Provider Business Practice Location Address Telephone Number:
787-816-5921
Provider Business Practice Location Address Fax Number:
787-816-5837
Provider Enumeration Date:
05/08/2008

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:  4583 , 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)





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