Provider Demographics
NPI:1417042813
Name:MORALES, OLGA M (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:M
Last Name:MORALES
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O.BOX 335 VICTORIA STATION
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00605-0335
Mailing Address - Country:US
Mailing Address - Phone:178-788-2443
Mailing Address - Fax:
Practice Address - Street 1:AVE SAN CARLOS ESQ COMERCIO
Practice Address - Street 2:
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00605-0335
Practice Address - Country:US
Practice Address - Phone:178-788-2443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1599183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1835G0000XOtherPHARMACIST