Basic Information
Provider Information
NPI: 1831673573
EntityType: 2
ReplacementNPI:  
OrganizationName: UNITED THREE BROTHERS INC.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
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Mailing Information
Address1: PO BOX 4218
Address2:  
City: BAYAMON
State: PR
PostalCode: 009581218
CountryCode: US
TelephoneNumber: 7875471991
FaxNumber: 7872690022
Practice Location
Address1: 1498 AVENIDA ROOSEVELT LOCAL 19A
Address2: PLAZA CAPARRA SHOPPING CENTER
City: GUAYNABO
State: PR
PostalCode: 00968
CountryCode: US
TelephoneNumber: 7877866382
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/19/2018
LastUpdateDate: 11/10/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: YASSIN
AuthorizedOfficialFirstName: MANNA
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CIO/CFO
AuthorizedOfficialTelephone: 7875471991
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: UNITED THREE BROTHERS INC.
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/10/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
3336C0003X  Y SuppliersPharmacyCommunity/Retail Pharmacy

No ID Information.


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