Provider Demographics
NPI:1467880575
Name:CARDINAL HEALTH P.R 120
Entity type:Organization
Organization Name:CARDINAL HEALTH P.R 120
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:JOANNE
Authorized Official - Last Name:DANNER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:787-625-4354
Mailing Address - Street 1:CARR 165 # KM 2/4
Mailing Address - Street 2:BUILDING 10 LOCAL B
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00968-8058
Mailing Address - Country:US
Mailing Address - Phone:787-625-4100
Mailing Address - Fax:787-625-4138
Practice Address - Street 1:CARR 165 # KM 2/4
Practice Address - Street 2:BUILDING 10 LOCAL B
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968-8058
Practice Address - Country:US
Practice Address - Phone:787-625-4100
Practice Address - Fax:787-625-4138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-29
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRFMR 00001-143336N0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336N0007XSuppliersPharmacyNuclear Pharmacy