Provider Demographics
NPI:1225136211
Name:RADAMES R. SANTIAGO, INC.
Entity Type:Organization
Organization Name:RADAMES R. SANTIAGO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RADAMES
Authorized Official - Middle Name:RUFINO
Authorized Official - Last Name:SANTIAGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-736-3221
Mailing Address - Street 1:51 CALLE MUNOZ RIVERA S
Mailing Address - Street 2:
Mailing Address - City:SAN LORENZO
Mailing Address - State:PR
Mailing Address - Zip Code:00754-3917
Mailing Address - Country:US
Mailing Address - Phone:787-736-3221
Mailing Address - Fax:
Practice Address - Street 1:51 CALLE MUNOZ RIVERA S
Practice Address - Street 2:
Practice Address - City:SAN LORENZO
Practice Address - State:PR
Practice Address - Zip Code:00754-3917
Practice Address - Country:US
Practice Address - Phone:787-736-3221
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07-F-07793336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy