Pancho Blu LLC Dba Farmacias Aliadas Gurabo

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

15F3115 Issued in PR

Legal business name

PANCHO BLU LLC DBA FARMACIAS ALIADAS GURABO

Practice address

Rd 189 Ralph'S Plaza
Suite 6
Gurabo, PR 00778

Phone

(787) 736-7100

Fax

(787) 736-0300

NPI assigned

Mar 19, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Edward Saez

Title

President

Phone

(787) 736-7100

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1363651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363651200000",
    "number": "1376885251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "STREET 4 #150 URB EL PARQUE",
            "city": "SAN LORENZO",
            "state": "PR",
            "postal_code": "00754",
            "telephone_number": "787-736-7100",
            "fax_number": "787-736-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RD 189 RALPH'S PLAZA",
            "address_2": "SUITE 6",
            "city": "GURABO",
            "state": "PR",
            "postal_code": "00778",
            "telephone_number": "787-736-7100",
            "fax_number": "787-736-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANCHO BLU LLC DBA FARMACIAS ALIADAS GURABO",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-19",
        "last_updated": "2013-03-19",
        "status": "A",
        "authorized_official_last_name": "SAEZ",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-736-7100"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PR",
            "license": "15F3115",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "PR",
            "license": "15F3115",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amarilis Padilla Lugo, MD
• Nattasha I Padilla Nevarez
• Sylvia Paez, M.D.
• Ketsy Pagan Mercado, MD
• Ashley Ann Pagan Reyes
• Pediatric Professionals, CSP
• Andrea Paola Pereira Rodriguez, MD
• Yashira Marie Perez Agosto, AUXILIAR DE FARMACIA
• Gabriel Hiram Perez Rivera, BSN-RN
• Marcos A. Perez-Martinez, REGISTERED NURSE

• Community/Retail Pharmacy in Gurabo, PR
• Providers in Gurabo, PR by specialty
• Community/Retail Pharmacy in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.