Provider Demographics
NPI:1790136059
Name:ABC UNLIMITED PHARMACY SERVICES, CORP
Entity Type:Organization
Organization Name:ABC UNLIMITED PHARMACY SERVICES, CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:COLON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:787-460-5378
Mailing Address - Street 1:655 AVE SAN PATRICIO
Mailing Address - Street 2:URB SUMMIT HILLS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921
Mailing Address - Country:US
Mailing Address - Phone:939-204-1991
Mailing Address - Fax:939-204-5906
Practice Address - Street 1:2225 PONCE BYP STE 607
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1379
Practice Address - Country:US
Practice Address - Phone:787-841-1212
Practice Address - Fax:787-841-1149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-28
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18-F-33523336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR=========OtherEIN