Provider Demographics
NPI:1922258854
Name:EL BOTINQUIN DE CUPEY INC
Entity Type:Organization
Organization Name:EL BOTINQUIN DE CUPEY INC
Other - Org Name:EL BOTINQUIN DE CUPEY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RPH
Authorized Official - Prefix:
Authorized Official - First Name:LYDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-982-2323
Mailing Address - Street 1:PO BOX 8729
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00910-0729
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:URB PURPLE TREE
Practice Address - Street 2:1749 CARR 844
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-4446
Practice Address - Country:US
Practice Address - Phone:787-755-1600
Practice Address - Fax:787-755-1668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-29
Last Update Date:2010-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10F26333336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4026476OtherNCPDP PROVIDER IDENTIFICATION NUMBER