Provider Demographics
NPI:1063499705
Name:BANCHS, NILDA E (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:NILDA
Middle Name:E
Last Name:BANCHS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:VILLAS DEL SAGRADO CORAZON
Mailing Address - Street 2:A-13
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00730
Mailing Address - Country:US
Mailing Address - Phone:787-844-2805
Mailing Address - Fax:787-841-5551
Practice Address - Street 1:553 CALLE RAMOS ANTONINI
Practice Address - Street 2:EL TUQUE
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00728-4806
Practice Address - Country:US
Practice Address - Phone:787-844-2805
Practice Address - Fax:787-841-5551
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2365183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2365OtherPHARMACIST