Provider Demographics
NPI:1790827889
Name:A. CORDERO BADILLO ,INC
Entity Type:Organization
Organization Name:A. CORDERO BADILLO ,INC
Other - Org Name:FARMACIA GRANDE SAN LORENZO
Other - Org Type:Other Name
Authorized Official - Title/Position:PHARMACY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LINNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:VALLELLANES
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:787-638-8955
Mailing Address - Street 1:PO BOX 458
Mailing Address - Street 2:
Mailing Address - City:CATANO
Mailing Address - State:PR
Mailing Address - Zip Code:00963-0458
Mailing Address - Country:US
Mailing Address - Phone:787-638-8955
Mailing Address - Fax:787-715-1771
Practice Address - Street 1:183 SAN LORENZO SHOPPING CENTER
Practice Address - Street 2:
Practice Address - City:SAN LORENZO
Practice Address - State:PR
Practice Address - Zip Code:00754
Practice Address - Country:US
Practice Address - Phone:787-715-1770
Practice Address - Fax:787-715-1771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy