Provider Demographics
NPI:1790926285
Name:UNIVERSAL PHARMACY SUPPLIES CORP
Entity Type:Organization
Organization Name:UNIVERSAL PHARMACY SUPPLIES CORP
Other - Org Name:UNIVERSAL PHARMACY SUPPLIES, CORP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:787-254-1000
Mailing Address - Street 1:PO BOX 1563
Mailing Address - Street 2:
Mailing Address - City:LAJAS
Mailing Address - State:PR
Mailing Address - Zip Code:00667-1563
Mailing Address - Country:US
Mailing Address - Phone:787-254-1000
Mailing Address - Fax:787-254-1015
Practice Address - Street 1:CARR 308 KM 3.2
Practice Address - Street 2:BO PUERTO REAL
Practice Address - City:CABO ROJO
Practice Address - State:PR
Practice Address - Zip Code:00623
Practice Address - Country:US
Practice Address - Phone:787-254-1000
Practice Address - Fax:787-254-1015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-13
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15-F-2996333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2119487OtherPK