Provider Demographics
NPI:1043494925
Name:AGUADILLA MEDICAL SERVICES, INC.
Entity Type:Organization
Organization Name:AGUADILLA MEDICAL SERVICES, INC.
Other - Org Name:FARMACIA AGUADILLA MEDICAL SERVICES, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:DEL C
Authorized Official - Last Name:VARGS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-882-0303
Mailing Address - Street 1:PO BOX 250479
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00604-0479
Mailing Address - Country:US
Mailing Address - Phone:787-882-0303
Mailing Address - Fax:787-997-1680
Practice Address - Street 1:CARRETERA #2 KM. 129.3 BO. VICTORIA
Practice Address - Street 2:
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:787-882-0303
Practice Address - Fax:787-997-1680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR09-F-1428333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy