Provider Demographics
NPI:1184846651
Name:ONE STOP LAS AMERICAS
Entity Type:Organization
Organization Name:ONE STOP LAS AMERICAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:DEL PILAR
Authorized Official - Last Name:MARIN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:787-777-0411
Mailing Address - Street 1:PO BOX 1620
Mailing Address - Street 2:
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00977-1620
Mailing Address - Country:US
Mailing Address - Phone:787-777-0411
Mailing Address - Fax:787-777-0409
Practice Address - Street 1:SUPERMERCADO PUEBLO
Practice Address - Street 2:CENTRO COMERCIAL PLAZA LAS AMERICAS ESQ. CALLE CALAF
Practice Address - City:SAN JUAN
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00919
Practice Address - Country:UM
Practice Address - Phone:787-777-0411
Practice Address - Fax:787-777-0409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR09F2165332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR5358300001Medicare ID - Type UnspecifiedPHARMACY