1023172863 NPI number — PMC MARKETING CORP

Table of content: (NPI 1023172863)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023172863 NPI number — PMC MARKETING CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PMC MARKETING CORP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
FARMACIA EL AMAL # 63
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1023172863
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 29166
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00929-0166
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-641-3888
Provider Business Mailing Address Fax Number:
787-756-0160

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
PLAZA BORINQUEN SHOPPING CENTER
Provider Second Line Business Practice Location Address:
CARR 107 KM 3.1
Provider Business Practice Location Address City Name:
AGUADILLA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00605
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-819-0209
Provider Business Practice Location Address Fax Number:
787-819-0270
Provider Enumeration Date:
12/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
YASSIN
Authorized Official First Name:
SULTAN
Authorized Official Middle Name:
SALEH
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
787-641-3888

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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