Provider Demographics
NPI:1114577350
Name:FARMACIA LA CHIMENEA
Entity type:Organization
Organization Name:FARMACIA LA CHIMENEA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST CHIEF
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLINE
Authorized Official - Middle Name:RAQUEL
Authorized Official - Last Name:RIVERA ALVARADO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:787-987-8633
Mailing Address - Street 1:HC 2 BOX 5389
Mailing Address - Street 2:
Mailing Address - City:PENUELAS
Mailing Address - State:PR
Mailing Address - Zip Code:00624-9692
Mailing Address - Country:US
Mailing Address - Phone:787-987-8633
Mailing Address - Fax:787-987-8953
Practice Address - Street 1:CARRETERA PR-132 KM 8.7
Practice Address - Street 2:
Practice Address - City:PENUELAS
Practice Address - State:PR
Practice Address - Zip Code:00624
Practice Address - Country:US
Practice Address - Phone:787-987-8633
Practice Address - Fax:787-987-8953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-19
Last Update Date:2025-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR039840200Medicaid