Provider Demographics
NPI:1174857767
Name:FARMACIA EL BUEN PASTOR #2
Entity Type:Organization
Organization Name:FARMACIA EL BUEN PASTOR #2
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LUIGGI
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-426-5522
Mailing Address - Street 1:CARR 420 KM 2.2
Mailing Address - Street 2:BARRIO VOLADORAS
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676
Mailing Address - Country:US
Mailing Address - Phone:787-877-9922
Mailing Address - Fax:787-877-9922
Practice Address - Street 1:HC 4 BOX 13792
Practice Address - Street 2:
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676-9656
Practice Address - Country:US
Practice Address - Phone:787-877-9922
Practice Address - Fax:787-877-9922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-29
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11-F-27253336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy