Provider Demographics
NPI:1417059437
Name:SALUD INTEGRAL EN LA MONTAA, INC
Entity Type:Organization
Organization Name:SALUD INTEGRAL EN LA MONTAA, INC
Other - Org Name:SALUD INTEGRAL EN LA MONTAA, INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PHARMACY TECHNICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-869-5900
Mailing Address - Street 1:HC-01 BOX 5394
Mailing Address - Street 2:
Mailing Address - City:BARRANQUITAS
Mailing Address - State:PR
Mailing Address - Zip Code:00794
Mailing Address - Country:US
Mailing Address - Phone:787-359-1659
Mailing Address - Fax:
Practice Address - Street 1:CARR 152 KM.12 HM. 4
Practice Address - Street 2:BOX 515
Practice Address - City:NARANJITO
Practice Address - State:PR
Practice Address - Zip Code:00719-0515
Practice Address - Country:US
Practice Address - Phone:787-869-5900
Practice Address - Fax:787-722-6980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1716183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183700000XPharmacy Service ProvidersPharmacy TechnicianGroup - Single Specialty