Provider Demographics
NPI:1144236886
Name:QUALITY SERVICE PHARMACY INC
Entity Type:Organization
Organization Name:QUALITY SERVICE PHARMACY INC
Other - Org Name:FARMACIA QUEBRADILLAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LOUISETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:787-895-6006
Mailing Address - Street 1:PO BOX 686
Mailing Address - Street 2:
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00627-0686
Mailing Address - Country:US
Mailing Address - Phone:787-895-6006
Mailing Address - Fax:787-895-0044
Practice Address - Street 1:CALLE SOCORRO
Practice Address - Street 2:# 155
Practice Address - City:QUEBRADILLAS
Practice Address - State:PR
Practice Address - Zip Code:00678
Practice Address - Country:US
Practice Address - Phone:787-895-6006
Practice Address - Fax:787-895-0044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
PR18F26013336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2085083OtherPK