Provider Demographics
NPI:1932506854
Name:CAMUY HEALTH SERVICES
Entity Type:Organization
Organization Name:CAMUY HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:D
Authorized Official - Last Name:LUGO-CARABALLO
Authorized Official - Suffix:
Authorized Official - Credentials:RPH, PHARMD
Authorized Official - Phone:787-898-2604
Mailing Address - Street 1:63 AVE MUNOZ RIVERA E
Mailing Address - Street 2:
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00627-2630
Mailing Address - Country:US
Mailing Address - Phone:787-898-2604
Mailing Address - Fax:787-262-4822
Practice Address - Street 1:63 AVE MUNOZ RIVERA E
Practice Address - Street 2:
Practice Address - City:CAMUY
Practice Address - State:PR
Practice Address - Zip Code:00627-2630
Practice Address - Country:US
Practice Address - Phone:787-898-2660
Practice Address - Fax:787-262-1210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-20
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4729261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4729OtherPR LICENSE