Provider Demographics
NPI:1225195332
Name:QUALITY CARE PHARMACY
Entity Type:Organization
Organization Name:QUALITY CARE PHARMACY
Other - Org Name:SUPER FARMACIA PACO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NELSON
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMACHO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-424-3913
Mailing Address - Street 1:PO BOX 967
Mailing Address - Street 2:
Mailing Address - City:BAJADERO
Mailing Address - State:PR
Mailing Address - Zip Code:00616-0967
Mailing Address - Country:US
Mailing Address - Phone:787-881-7872
Mailing Address - Fax:787-880-9066
Practice Address - Street 1:CARR 662 CALLE MARGINAL BO. SANTANA
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-881-7872
Practice Address - Fax:787-880-9066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17-F-29483336C0003X
3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2131199OtherPK