Provider Demographics
NPI:1164648127
Name:FARMACIA DEL CONDADO
Entity Type:Organization
Organization Name:FARMACIA DEL CONDADO
Other - Org Name:ZOE PEREZ
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRADORA
Authorized Official - Prefix:
Authorized Official - First Name:ZOE
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:AUXDE FARMACIA
Authorized Official - Phone:787-743-0001
Mailing Address - Street 1:URB QUINONEZ JIMENEZ AVE JOSE VILLARES
Mailing Address - Street 2:SOLAR #1
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:787-743-0001
Mailing Address - Fax:787-286-2516
Practice Address - Street 1:URB QUINONEZ JIMENEZ AVE JOSE VILLARES
Practice Address - Street 2:SOLAR #1
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-743-0001
Practice Address - Fax:787-286-2516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR08-F-24493336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy