Provider Demographics
NPI:1740425487
Name:NIEVES, HELEN (RPH)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:
Last Name:NIEVES
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CAMINO LOS COROZOS #168
Mailing Address - Street 2:URB SABANERA DEL RIO
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778
Mailing Address - Country:US
Mailing Address - Phone:787-567-1329
Mailing Address - Fax:
Practice Address - Street 1:AVE LUIS MUNOZ MARIN PLAZA CENTRO II
Practice Address - Street 2:SAM'S CLUB PHARMACY
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-746-1039
Practice Address - Fax:787-746-1086
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-10
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4506183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist