| NPI | 1811060395 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE RAUL DIEPPA President 787-258-0805 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: SC 4916200001) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: PR DF-02290-5) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2020-08-22 |