Provider Demographics
NPI:1235437054
Name:FARMACIA GLORIANA INC.
Entity Type:Organization
Organization Name:FARMACIA GLORIANA INC.
Other - Org Name:FARMACIA GLORIANA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MERCADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-895-1067
Mailing Address - Street 1:42905 CARR 482
Mailing Address - Street 2:
Mailing Address - City:QUEBRADILLAS
Mailing Address - State:PR
Mailing Address - Zip Code:00678-9319
Mailing Address - Country:US
Mailing Address - Phone:787-895-2895
Mailing Address - Fax:787-895-1067
Practice Address - Street 1:CARR.2 KM.96.8
Practice Address - Street 2:BO.COCOS
Practice Address - City:QUEBRADILLAS
Practice Address - State:PR
Practice Address - Zip Code:00678
Practice Address - Country:US
Practice Address - Phone:787-895-2895
Practice Address - Fax:787-895-1067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-02
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07F0674333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy