Provider Demographics
NPI:1841208998
Name:MARCANO, CARMEN LOURDES (RPH)
Entity Type:Individual
Prefix:MRS
First Name:CARMEN
Middle Name:LOURDES
Last Name:MARCANO
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:E7 CALLE CELESTE
Mailing Address - Street 2:HORIZONTES
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-4024
Mailing Address - Country:US
Mailing Address - Phone:787-439-4809
Mailing Address - Fax:787-258-7496
Practice Address - Street 1:28 CALLE GOYCO
Practice Address - Street 2:
Practice Address - City:NAGUABO
Practice Address - State:PR
Practice Address - Zip Code:00718-2255
Practice Address - Country:US
Practice Address - Phone:787-874-5092
Practice Address - Fax:787-874-2777
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3298183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist