Provider Demographics
NPI:1245379023
Name:ORLANDO RIVERA FARMACIA MI SUENO
Entity Type:Organization
Organization Name:ORLANDO RIVERA FARMACIA MI SUENO
Other - Org Name:FARMACIA MI SUENO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:ORLANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-891-6969
Mailing Address - Street 1:PO BOX 4023
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00605-4023
Mailing Address - Country:US
Mailing Address - Phone:787-891-6969
Mailing Address - Fax:787-891-6969
Practice Address - Street 1:CARR 2 KM 123 PT 7
Practice Address - Street 2:BARRIO CAIMITAL ALTO
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00605
Practice Address - Country:US
Practice Address - Phone:787-891-6969
Practice Address - Fax:787-891-6969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
PR18F33533336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2087320OtherPK