Provider Demographics
NPI:1164827267
Name:FARMACIA EMPRESA MUNICIPAL SALUD INTEGRAL DE LA TIERRA ALTA
Entity Type:Organization
Organization Name:FARMACIA EMPRESA MUNICIPAL SALUD INTEGRAL DE LA TIERRA ALTA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GERENTE ADMINISTRATIVO
Authorized Official - Prefix:MRS
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:I
Authorized Official - Last Name:ZAMORA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-828-0305
Mailing Address - Street 1:PO BOX 410
Mailing Address - Street 2:
Mailing Address - City:JAYUYA
Mailing Address - State:PR
Mailing Address - Zip Code:00664-0410
Mailing Address - Country:US
Mailing Address - Phone:787-828-0305
Mailing Address - Fax:787-828-0901
Practice Address - Street 1:2 CALLE ROSANTA AULET
Practice Address - Street 2:
Practice Address - City:JAYUYA
Practice Address - State:PR
Practice Address - Zip Code:00664-1328
Practice Address - Country:US
Practice Address - Phone:787-828-0305
Practice Address - Fax:787-828-0901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-31
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336I0012XSuppliersPharmacyInstitutional Pharmacy