Provider Demographics
NPI:1801925375
Name:RIVERA, MERALYS (PHARMACY TECH)
Entity type:Individual
Prefix:MRS
First Name:MERALYS
Middle Name:
Last Name:RIVERA
Suffix:
Gender:F
Credentials:PHARMACY TECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 124
Mailing Address - Street 2:
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00792
Mailing Address - Country:US
Mailing Address - Phone:787-914-3793
Mailing Address - Fax:787-285-4055
Practice Address - Street 1:STREET NEYA Y HERNANDEZ 2
Practice Address - Street 2:FARMACIA MARISEL # 1
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00792
Practice Address - Country:US
Practice Address - Phone:787-852-4180
Practice Address - Fax:787-285-4055
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2900183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician