Provider Demographics
NPI:1336679331
Name:PAO'S PHARMACY, INC
Entity Type:Organization
Organization Name:PAO'S PHARMACY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARIA
Authorized Official - Prefix:MRS
Authorized Official - First Name:GISELLE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ROLON VARGAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-463-3519
Mailing Address - Street 1:232 CALLE 22
Mailing Address - Street 2:URB LA ARBOLEDA
Mailing Address - City:SALINAS
Mailing Address - State:PR
Mailing Address - Zip Code:00751
Mailing Address - Country:US
Mailing Address - Phone:787-463-3519
Mailing Address - Fax:787-803-3111
Practice Address - Street 1:2 CALLE WILLIE ROSARIO
Practice Address - Street 2:
Practice Address - City:COAMO
Practice Address - State:PR
Practice Address - Zip Code:00769-3289
Practice Address - Country:US
Practice Address - Phone:787-803-3777
Practice Address - Fax:787-803-3111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-13
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19-F-34993336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy