Provider Demographics
NPI:1043252679
Name:FAMILY DRUG CENTER INC
Entity Type:Organization
Organization Name:FAMILY DRUG CENTER INC
Other - Org Name:SARIMAR DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:SOTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-760-1770
Mailing Address - Street 1:352 CALLE SAN GENARO
Mailing Address - Street 2:URB S. CORAZON
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-4129
Mailing Address - Country:US
Mailing Address - Phone:787-760-1280
Mailing Address - Fax:787-283-3673
Practice Address - Street 1:CARR 176 ESQ. AVE. SAN CLAUDIO
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-760-1280
Practice Address - Fax:787-283-3673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
PR15-F-10383336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2085708OtherPK