Provider Demographics
NPI:1881725265
Name:PUERTO RICO DRUG COMPANY, INC
Entity type:Organization
Organization Name:PUERTO RICO DRUG COMPANY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGENT PHARMACIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ZORAIDA
Authorized Official - Middle Name:E
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:787-725-2202
Mailing Address - Street 1:PO BOX 9023833
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00902-3833
Mailing Address - Country:US
Mailing Address - Phone:787-725-2202
Mailing Address - Fax:787-977-0204
Practice Address - Street 1:157 CALLE DE SAN FRANCISCO
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00901-1607
Practice Address - Country:US
Practice Address - Phone:787-725-2202
Practice Address - Fax:787-977-0204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07-F-06653336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4014320OtherNABP