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Provider Information for 1245809862


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CORPORACION DE SERVICIOS DE SALUD Y MEDICINA AVANZADA COSSMA

Other Names:  
Other Name: 
FARMACIA COSSMA AIBONITO

Organization Subpart: NO

NPI: 1245809862
Last Updated: 2021-10-21
Certification Date: 2021-10-21

Details

NameValue
NPI1245809862
Enumeration Date2021-06-18
NPI TypeNPI-2 Organization
StatusActive
Authorized Official Information Name: JACKELINE BERNARD MILIAN
Title: BILLING MANAGER
Phone: 7877398182
Mailing Address PO BOX 1330
CIDRA, PR 00739-1330
United States

Phone: 787-739-8182 | Fax:
 
Primary Practice Address PR-14 KM 80.4 PARQUE INDUSTRIAL BO PUEBLO
AIBONITO, PR 00705
United States

Phone: 787-739-8182 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 333600000X - Pharmacy