Provider Demographics
NPI:1154308716
Name:SAN PEDRITO, LLC
Entity Type:Organization
Organization Name:SAN PEDRITO, LLC
Other - Org Name:FARMACIA ARLEEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:PEIRATAS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:787-746-5952
Mailing Address - Street 1:PO BOX 5986
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-5986
Mailing Address - Country:US
Mailing Address - Phone:787-746-5952
Mailing Address - Fax:787-744-3397
Practice Address - Street 1:VILLA DEL REY 3RA SECC
Practice Address - Street 2:CARR 172 ESQ ASTURIAS
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-7113
Practice Address - Country:US
Practice Address - Phone:787-746-5952
Practice Address - Fax:787-744-3397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-26
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR09F02043336C0003X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy