Provider Demographics
NPI:1386895530
Name:ABSOLUTE PHARMACY, INC.
Entity type:Organization
Organization Name:ABSOLUTE PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:OMARYS
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:787-892-8700
Mailing Address - Street 1:HC 3 BOX 25711
Mailing Address - Street 2:
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683-9340
Mailing Address - Country:US
Mailing Address - Phone:787-892-8700
Mailing Address - Fax:787-264-5800
Practice Address - Street 1:CARR 2 KM 174.0 BO. CAIN ALTO
Practice Address - Street 2:SUITE 107 OFICINA 1-A
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683-9340
Practice Address - Country:US
Practice Address - Phone:787-892-8700
Practice Address - Fax:787-264-5800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-07
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10-F-26713336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR6402340001OtherPTAN (PROVIDER TRANSACTION ACCESS NUMBER)
PR6402340001Medicare NSC