Provider Demographics
NPI:1073644571
Name:FARMACIA DEL CARMEN
Entity Type:Organization
Organization Name:FARMACIA DEL CARMEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SAUDHI
Authorized Official - Middle Name:E
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:787-872-4777
Mailing Address - Street 1:89 CALLE MANUEL CORCHADO JUARBE
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-2622
Mailing Address - Country:US
Mailing Address - Phone:787-872-4777
Mailing Address - Fax:787-872-4777
Practice Address - Street 1:89 CALLE MANUEL CORCHADO JUARBE
Practice Address - Street 2:
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662-2622
Practice Address - Country:US
Practice Address - Phone:787-872-4777
Practice Address - Fax:787-872-4777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07F20113336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4016449OtherNABP