Provider Demographics
NPI:1225431034
Name:NOVA PHARMACY 3 INC.
Entity Type:Organization
Organization Name:NOVA PHARMACY 3 INC.
Other - Org Name:NOVA PHARMACY
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GERARDO
Authorized Official - Middle Name:RIVERA
Authorized Official - Last Name:ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:ING
Authorized Official - Phone:787-375-0295
Mailing Address - Street 1:PO BOX 1050
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:PR
Mailing Address - Zip Code:00751-1050
Mailing Address - Country:US
Mailing Address - Phone:787-375-0295
Mailing Address - Fax:
Practice Address - Street 1:CARR.538 PLAZA LA CEIBA SHOOPING CENTER # 8
Practice Address - Street 2:BO. FELICIA II
Practice Address - City:SANTA ISABEL
Practice Address - State:PR
Practice Address - Zip Code:00757
Practice Address - Country:US
Practice Address - Phone:787-375-0295
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy