Provider Demographics
NPI:1033248281
Name:ONE STOP PRESCRIPTION ALTAMIRA, INC.
Entity Type:Organization
Organization Name:ONE STOP PRESCRIPTION ALTAMIRA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-749-0567
Mailing Address - Street 1:PMB 201
Mailing Address - Street 2:PO BOX 7891
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:AVE. MARTINEZ NADAL, ESQ. AVE. J. T. PINERO
Practice Address - Street 2:PUEBLO SUPERMARKET
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00970-0000
Practice Address - Country:US
Practice Address - Phone:787-749-0567
Practice Address - Fax:787-273-2121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR09-F-22703336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy