Provider Demographics
NPI:1427698596
Name:MARCHESE, RICARDO ALBERTO (RPH,BSPH)
Entity type:Individual
Prefix:
First Name:RICARDO
Middle Name:ALBERTO
Last Name:MARCHESE
Suffix:
Gender:M
Credentials:RPH,BSPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 1 BOX 2116
Mailing Address - Street 2:
Mailing Address - City:LAS MARIAS
Mailing Address - State:PR
Mailing Address - Zip Code:00670-9407
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CARR 119 KM 53.2 BO FURNIAS
Practice Address - Street 2:
Practice Address - City:LAS MARIAS
Practice Address - State:PR
Practice Address - Zip Code:00670
Practice Address - Country:US
Practice Address - Phone:787-827-0339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-07
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4505183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty