Provider Demographics
NPI:1194856641
Name:FARMACIA LEMAR
Entity Type:Organization
Organization Name:FARMACIA LEMAR
Other - Org Name:IVONNE PONCE DE LEON
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:IVONNE
Authorized Official - Middle Name:
Authorized Official - Last Name:PONCE DE LEON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-856-1922
Mailing Address - Street 1:CENTRO COMERCIAL LA QUINTA
Mailing Address - Street 2:25 DE JULIO STREET
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698
Mailing Address - Country:US
Mailing Address - Phone:787-856-1922
Mailing Address - Fax:787-856-1922
Practice Address - Street 1:CENTRO COMERCIAL LA QUINTA
Practice Address - Street 2:
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698
Practice Address - Country:US
Practice Address - Phone:787-856-1922
Practice Address - Fax:787-856-1922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07-F-19103336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy