Provider Demographics
NPI:1215227269
Name:FARMACIA GUAYANES INC
Entity Type:Organization
Organization Name:FARMACIA GUAYANES INC
Other - Org Name:FARMACIA GUAYANES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-316-7464
Mailing Address - Street 1:EDIFICIO AURORA A -1
Mailing Address - Street 2:CALLE PEDRO VELAZQUEZ DIAZ # 628
Mailing Address - City:PENUELAS
Mailing Address - State:PR
Mailing Address - Zip Code:00624
Mailing Address - Country:US
Mailing Address - Phone:787-836-3131
Mailing Address - Fax:787-836-3130
Practice Address - Street 1:EDIFICIO AURORA A -1
Practice Address - Street 2:CALLE PEDRO VELAZQUEZ DIAZ # 628
Practice Address - City:PENUELAS
Practice Address - State:PR
Practice Address - Zip Code:00624
Practice Address - Country:US
Practice Address - Phone:787-836-3131
Practice Address - Fax:787-836-3130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-12
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
PR19-F-29353336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2129848OtherPK