Provider Demographics
NPI:1043745342
Name:ALLERGAN SALES PUERTO RICO INC
Entity Type:Organization
Organization Name:ALLERGAN SALES PUERTO RICO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARIBBEAN VP
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:E
Authorized Official - Last Name:VIERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-407-4859
Mailing Address - Street 1:PO BOX 195409
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-5409
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CARR 1 KM 21.1
Practice Address - Street 2:SECTOR LA MUDA
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00971-9999
Practice Address - Country:US
Practice Address - Phone:787-766-4565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-24
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies