Provider Demographics
NPI:1104028083
Name:FARMACIA DEL CARMEN
Entity Type:Organization
Organization Name:FARMACIA DEL CARMEN
Other - Org Name:LUIS MARTINEZ GONZALEZ
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:NEGRIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-748-0880
Mailing Address - Street 1:CARR 844
Mailing Address - Street 2:BUZON 1390
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-748-0880
Mailing Address - Fax:787-760-1399
Practice Address - Street 1:CARR 844 KM 3.0
Practice Address - Street 2:CUPEY BAJO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-748-0880
Practice Address - Fax:787-760-1399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07F0920332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4010574OtherNCDP
PR4010574OtherNCDP