Provider Demographics
NPI:1447899760
Name:ROSARIO, NANCY (RPH)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:
Last Name:ROSARIO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HACIENDA LAS GARZAS
Mailing Address - Street 2:51 CALLE PARAISO
Mailing Address - City:RIO GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00745
Mailing Address - Country:US
Mailing Address - Phone:787-308-9087
Mailing Address - Fax:
Practice Address - Street 1:150 CARR. 940, STE 10
Practice Address - Street 2:
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738-3632
Practice Address - Country:US
Practice Address - Phone:787-863-3025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-03
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4468183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty