Provider Demographics
NPI:1316775604
Name:DM HEALTH GROUP LLC
Entity type:Organization
Organization Name:DM HEALTH GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER (PHARMACIST)
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID G.
Authorized Official - Middle Name:GUSTAVO
Authorized Official - Last Name:MENDOZA SOTO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:787-528-1941
Mailing Address - Street 1:HC 58 BOX 13460
Mailing Address - Street 2:
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602-9891
Mailing Address - Country:US
Mailing Address - Phone:787-528-1941
Mailing Address - Fax:
Practice Address - Street 1:CARR 416 KM 6.1 BO. LAGUNAS
Practice Address - Street 2:
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602
Practice Address - Country:US
Practice Address - Phone:787-252-0762
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-26
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy