Provider Demographics
NPI:1689257263
Name:EAST COMMUNITY PHARMACY
Entity Type:Organization
Organization Name:EAST COMMUNITY PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-801-0081
Mailing Address - Street 1:PO BOX 70006
Mailing Address - Street 2:
Mailing Address - City:FAJARDO
Mailing Address - State:PR
Mailing Address - Zip Code:00738-7006
Mailing Address - Country:US
Mailing Address - Phone:787-801-0081
Mailing Address - Fax:787-522-3583
Practice Address - Street 1:151 AVE OSVALDO MOLINA
Practice Address - Street 2:
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738-4013
Practice Address - Country:US
Practice Address - Phone:787-801-0081
Practice Address - Fax:787-522-3583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-03
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy