Provider Demographics
NPI:1346764362
Name:TO GO PHARMACY & MEDICAL SUPPLY LLC
Entity type:Organization
Organization Name:TO GO PHARMACY & MEDICAL SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-530-0071
Mailing Address - Street 1:PO BOX 1792
Mailing Address - Street 2:
Mailing Address - City:SABANA SECA
Mailing Address - State:PR
Mailing Address - Zip Code:00952-1792
Mailing Address - Country:US
Mailing Address - Phone:787-530-0071
Mailing Address - Fax:
Practice Address - Street 1:URB BARALT G-10 LOCAL 2
Practice Address - Street 2:
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738-1792
Practice Address - Country:US
Practice Address - Phone:787-468-4850
Practice Address - Fax:787-468-4852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-01
Last Update Date:2017-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy