Provider Demographics
NPI:1154456135
Name:CAMACHO, NANCY NOEMI (PHARMACIST)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:NOEMI
Last Name:CAMACHO
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 80 BOX 7818
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-9555
Mailing Address - Country:US
Mailing Address - Phone:787-883-5451
Mailing Address - Fax:
Practice Address - Street 1:36 CALLE MUNOZ RIVERA
Practice Address - Street 2:
Practice Address - City:VEGA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00692-6530
Practice Address - Country:US
Practice Address - Phone:787-883-4140
Practice Address - Fax:787-270-3526
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4252183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist