Basic Information
| Provider Information | |||||||||
| NPI: | 1215402342 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | UNITED THREE BROS INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 4218 | ||||||||
| Address2: | |||||||||
| City: | BAYAMON | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009581218 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 1787547199 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1922 RAMIREZ DE ARELLANO | ||||||||
| Address2: | TORRIMAR SHOPPING CENTER | ||||||||
| City: | GUAYNABO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00966 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877877733 | ||||||||
| FaxNumber: | 7872690022 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2018 | ||||||||
| LastUpdateDate: | 10/04/2018 | ||||||||
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| AuthorizedOfficialLastName: | YASSIN | ||||||||
| AuthorizedOfficialFirstName: | MANNA | ||||||||
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| AuthorizedOfficialTitleorPosition: | CIO/CFO | ||||||||
| AuthorizedOfficialTelephone: | 7875471991 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | UNITED THREE BROS INC. | ||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 333600000X | N | Suppliers | Pharmacy | 3336C0003X | Y | Suppliers | Pharmacy | Community/Retail Pharmacy |
No ID Information.