Provider Demographics
NPI:1205045689
Name:FARMACIA CEDROS
Entity Type:Organization
Organization Name:FARMACIA CEDROS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DUENA
Authorized Official - Prefix:MRS
Authorized Official - First Name:AIDA
Authorized Official - Middle Name:LIZ
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-768-0500
Mailing Address - Street 1:HC 1 BOX 11824
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987
Mailing Address - Country:US
Mailing Address - Phone:787-768-0500
Mailing Address - Fax:787-768-0500
Practice Address - Street 1:CARR 185 KM 127 BO CEDROS
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987
Practice Address - Country:US
Practice Address - Phone:787-768-0500
Practice Address - Fax:787-768-0500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
09 F 1401333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy