Provider Demographics
NPI:1780718502
Name:AYALA, JESUS E (REGISTERED PHARMACIS)
Entity type:Individual
Prefix:MR
First Name:JESUS
Middle Name:E
Last Name:AYALA
Suffix:
Gender:M
Credentials:REGISTERED PHARMACIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6066
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681
Mailing Address - Country:US
Mailing Address - Phone:787-826-8888
Mailing Address - Fax:787-826-7777
Practice Address - Street 1:FARMACIA LAS COLINAS BO LAS MARIAS CAM 40 LUIZO
Practice Address - Street 2:COMERCIAL FELIBERTI
Practice Address - City:ANASCO
Practice Address - State:PR
Practice Address - Zip Code:00610
Practice Address - Country:US
Practice Address - Phone:787-826-8888
Practice Address - Fax:787-826-7777
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4760183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist