Provider Demographics
NPI:1336537273
Name:ALLMED PHARMACY LLC
Entity Type:Organization
Organization Name:ALLMED PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ADALBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:LLERA ROLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-686-6464
Mailing Address - Street 1:PO BOX 1918
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00785-1918
Mailing Address - Country:US
Mailing Address - Phone:787-686-6464
Mailing Address - Fax:787-686-6463
Practice Address - Street 1:STREET 54 INT. 3 COMMERCE PLAZA
Practice Address - Street 2:SUITE 101 GB-H
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00785-1918
Practice Address - Country:US
Practice Address - Phone:787-686-6464
Practice Address - Fax:787-686-6463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-30
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16-F-32383336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR16-F-3238OtherPHARMACY STATE LIC.