Provider Demographics
NPI:1912061904
Name:GC PHARMACY GROUP LLC
Entity Type:Organization
Organization Name:GC PHARMACY GROUP LLC
Other - Org Name:FARMACIA GLORIVEE III
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GLORIVEE
Authorized Official - Middle Name:
Authorized Official - Last Name:CORTES
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:787-382-5110
Mailing Address - Street 1:CALLE COLON # 252
Mailing Address - Street 2:
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602-3166
Mailing Address - Country:US
Mailing Address - Phone:787-868-8544
Mailing Address - Fax:787-868-8544
Practice Address - Street 1:CALLE COLON # 252 BO. PUEBLO
Practice Address - Street 2:
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602-3166
Practice Address - Country:US
Practice Address - Phone:787-868-8544
Practice Address - Fax:787-868-8544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19-F-34163336C0003X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2167824OtherPK