Provider Demographics
NPI:1164897757
Name:GONZALEZ PHARMACY CARE, CORP
Entity Type:Organization
Organization Name:GONZALEZ PHARMACY CARE, CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VIRGEN
Authorized Official - Middle Name:Y
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-280-3811
Mailing Address - Street 1:HC 6 BOX 17651
Mailing Address - Street 2:
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685-9884
Mailing Address - Country:US
Mailing Address - Phone:787-280-3811
Mailing Address - Fax:787-280-3810
Practice Address - Street 1:CARRETERA 111 KM 17.7
Practice Address - Street 2:BO. GUATEMALA
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685
Practice Address - Country:US
Practice Address - Phone:787-245-3093
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-08
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy