Provider Demographics
NPI:1093884744
Name:SANTIAGO R VARELA
Entity Type:Organization
Organization Name:SANTIAGO R VARELA
Other - Org Name:FARMACIA DEL CARMEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SANTIAGO
Authorized Official - Middle Name:R
Authorized Official - Last Name:VARELA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-826-2390
Mailing Address - Street 1:PO BOX 357
Mailing Address - Street 2:
Mailing Address - City:ANASCO
Mailing Address - State:PR
Mailing Address - Zip Code:00610
Mailing Address - Country:US
Mailing Address - Phone:787-826-2390
Mailing Address - Fax:787-826-7991
Practice Address - Street 1:CALLE 65 DE INFANTERIA #68
Practice Address - Street 2:
Practice Address - City:ANASCO
Practice Address - State:PR
Practice Address - Zip Code:00610
Practice Address - Country:US
Practice Address - Phone:787-826-2390
Practice Address - Fax:787-826-7991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07F18093336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4000840OtherNABP
PRDF-02437-2OtherASSMCA REGISTRATION
PR07-F-1809OtherRETAIL PHARMACY LICENSE
PRBF6611695OtherDEA REGISTRATION NUMBER