Provider Demographics
NPI:1578004180
Name:CORTES PHARMACY GROUP LLC
Entity Type:Organization
Organization Name:CORTES PHARMACY GROUP LLC
Other - Org Name:FARMACIA GENESIS II
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:GLORIVEE
Authorized Official - Middle Name:
Authorized Official - Last Name:CORTES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-229-1313
Mailing Address - Street 1:59 CALLE DAGUEY
Mailing Address - Street 2:
Mailing Address - City:ANASCO
Mailing Address - State:PR
Mailing Address - Zip Code:00610-2602
Mailing Address - Country:US
Mailing Address - Phone:787-826-4145
Mailing Address - Fax:787-826-3030
Practice Address - Street 1:CARR 109 KM 2 5 PLAZA SALCEDO
Practice Address - Street 2:
Practice Address - City:ANASCO
Practice Address - State:PR
Practice Address - Zip Code:00610
Practice Address - Country:US
Practice Address - Phone:787-826-4145
Practice Address - Fax:787-826-3030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-15
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2168170OtherPK