Provider Demographics
NPI:1265822415
Name:FARMACIA ALMIRANTE NORTE INC
Entity Type:Organization
Organization Name:FARMACIA ALMIRANTE NORTE INC
Other - Org Name:FARMACIA ALMIRANTE NORTE INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AURORA
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLAFRUELA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-917-0663
Mailing Address - Street 1:PO BOX 1765
Mailing Address - Street 2:
Mailing Address - City:VEGA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00692-1765
Mailing Address - Country:US
Mailing Address - Phone:787-917-0663
Mailing Address - Fax:787-917-0688
Practice Address - Street 1:BO ALMIRANTE NORTE
Practice Address - Street 2:CARR 160 KM 4.5
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693
Practice Address - Country:US
Practice Address - Phone:787-917-0663
Practice Address - Fax:787-917-0688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-27
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17-F-32553336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2150481OtherPK