Provider Demographics
NPI:1922699339
Name:LA NUEVA ESPERANZA
Entity Type:Organization
Organization Name:LA NUEVA ESPERANZA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:MADERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-649-7388
Mailing Address - Street 1:AVENIDA RAMON ARBONA 1050 BARRIO SABALOS
Mailing Address - Street 2:BARRIO SABALOS
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680
Mailing Address - Country:US
Mailing Address - Phone:787-649-7388
Mailing Address - Fax:
Practice Address - Street 1:AVENIDA RAMON ARBONA 1050 BARRIO SABALOS
Practice Address - Street 2:BARRIO SABALOS
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-649-7388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy