1790926285 NPI number — UNIVERSAL PHARMACY SUPPLIES CORP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790926285 NPI number — UNIVERSAL PHARMACY SUPPLIES CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSAL PHARMACY SUPPLIES CORP
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:
1790926285
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/20/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1563
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAJAS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00667-1563
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-254-1000
Provider Business Mailing Address Fax Number:
787-254-1015

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR 308 KM 3.2
Provider Second Line Business Practice Location Address:
BO PUERTO REAL
Provider Business Practice Location Address City Name:
CABO ROJO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00623
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-254-1000
Provider Business Practice Location Address Fax Number:
787-254-1015
Provider Enumeration Date:
03/13/2009

Additional Information

Authorized Official

Authorized Official Last Name:
MORALES
Authorized Official First Name:
ANGEL
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-254-1000

Provider Taxonomy Codes

  • Taxonomy code: 333600000X , with the licence number:  15-F-2996 , 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: 2119487 . This is a "PK" identifier . This identifiers is of the category "OTHER".




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