Provider Demographics
NPI:1376676312
Name:GONZALEZ JIMENEZ & SONS
Entity Type:Organization
Organization Name:GONZALEZ JIMENEZ & SONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:JIMENEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-859-7959
Mailing Address - Street 1:HC 05 BOX 10126
Mailing Address - Street 2:
Mailing Address - City:COROZAL
Mailing Address - State:PR
Mailing Address - Zip Code:00783-9569
Mailing Address - Country:US
Mailing Address - Phone:787-859-7959
Mailing Address - Fax:787-859-8128
Practice Address - Street 1:CARR 159 KM 84 BO PADILLA
Practice Address - Street 2:
Practice Address - City:COROZAL
Practice Address - State:PR
Practice Address - Zip Code:00783-9569
Practice Address - Country:US
Practice Address - Phone:787-859-7959
Practice Address - Fax:787-859-8128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy