Provider Demographics
NPI:1104039262
Name:FARMACIA SAN JOSE
Entity Type:Organization
Organization Name:FARMACIA SAN JOSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:EDGARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:787-898-2226
Mailing Address - Street 1:HC 3 BOX 11540
Mailing Address - Street 2:
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00627-9725
Mailing Address - Country:US
Mailing Address - Phone:787-898-2226
Mailing Address - Fax:787-898-2226
Practice Address - Street 1:CARRETERA NO. 2 KM. 93.1
Practice Address - Street 2:BO. MEMBRILLO
Practice Address - City:CAMUY
Practice Address - State:PR
Practice Address - Zip Code:00627-9713
Practice Address - Country:US
Practice Address - Phone:787-898-2226
Practice Address - Fax:787-898-2226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR09F13353336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy