Provider Demographics
NPI:1194918532
Name:CDT EULALIA KUILAN
Entity type:Organization
Organization Name:CDT EULALIA KUILAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY REGENT
Authorized Official - Prefix:
Authorized Official - First Name:NORMA
Authorized Official - Middle Name:VAZQUEZ
Authorized Official - Last Name:BADILLO
Authorized Official - Suffix:
Authorized Official - Credentials:LIC 1855 OF PR
Authorized Official - Phone:787-788-6089
Mailing Address - Street 1:P.O BOX 428
Mailing Address - Street 2:C.DT EULALIA KUILAN
Mailing Address - City:CATANO
Mailing Address - State:PR
Mailing Address - Zip Code:00963-0428
Mailing Address - Country:US
Mailing Address - Phone:787-788-1995
Mailing Address - Fax:787-275-0430
Practice Address - Street 1:CARR 869 BO PALMAS
Practice Address - Street 2:
Practice Address - City:CATANO
Practice Address - State:PR
Practice Address - Zip Code:00963-0428
Practice Address - Country:US
Practice Address - Phone:787-788-1995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-20
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR09F0946333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4021870OtherNABP