Provider Demographics
NPI:1114025046
Name:EL BOTIQUIN DE LA 26 INC
Entity Type:Organization
Organization Name:EL BOTIQUIN DE LA 26 INC
Other - Org Name:EL BOTIQUIN DE LA 26 PHCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:LYDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:787-982-2323
Mailing Address - Street 1:CALLE SAGRADO CORAZON
Mailing Address - Street 2:602
Mailing Address - City:SANTURCE
Mailing Address - State:PR
Mailing Address - Zip Code:00910
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CALLE SAGRADO CORAZON
Practice Address - Street 2:602
Practice Address - City:SANTURCE
Practice Address - State:PR
Practice Address - Zip Code:00910
Practice Address - Country:US
Practice Address - Phone:787-982-2323
Practice Address - Fax:787-982-2326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRDF0288783336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4025373OtherOTHER ID NUMBER-COMMERCIAL NUMBER