Provider Demographics
NPI:1194954693
Name:MARCHENA, LILLY BELL (PHARM D)
Entity type:Individual
Prefix:DR
First Name:LILLY
Middle Name:BELL
Last Name:MARCHENA
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 AVE TITO CASTRO STE 102 PMB 353
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716
Mailing Address - Country:US
Mailing Address - Phone:787-458-7695
Mailing Address - Fax:
Practice Address - Street 1:ROAD 2 KM 126.5
Practice Address - Street 2:4732 KMART PHARMACY
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00605
Practice Address - Country:US
Practice Address - Phone:787-819-1805
Practice Address - Fax:787-891-1980
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-07
Last Update Date:2009-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5396183500000X
FLPS44726183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist