Provider Demographics
NPI:1871702191
Name:OJEDA, ELENA (PHAS)
Entity type:Individual
Prefix:
First Name:ELENA
Middle Name:
Last Name:OJEDA
Suffix:
Gender:F
Credentials:PHAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4040
Mailing Address - Street 2:SUITE 483
Mailing Address - City:JUNCOS
Mailing Address - State:PR
Mailing Address - Zip Code:00777-7040
Mailing Address - Country:US
Mailing Address - Phone:787-210-6624
Mailing Address - Fax:
Practice Address - Street 1:5 CALLE ALMODOVAR
Practice Address - Street 2:FARMACIA LA INMACULADA
Practice Address - City:JUNCOS
Practice Address - State:PR
Practice Address - Zip Code:00777-3302
Practice Address - Country:US
Practice Address - Phone:787-734-4399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5176183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician