Provider Demographics
NPI:1295831725
Name:FARMACIA CANEY, INC
Entity Type:Organization
Organization Name:FARMACIA CANEY, INC
Other - Org Name:FARMACIA CANEY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ALFREDO
Authorized Official - Middle Name:JOSE
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:RPH
Authorized Official - Phone:787-283-3260
Mailing Address - Street 1:A9 CALLE ARACIBO
Mailing Address - Street 2:URB. CANEY
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-3552
Mailing Address - Country:US
Mailing Address - Phone:787-755-7845
Mailing Address - Fax:787-283-3486
Practice Address - Street 1:A9 CALLE ARACIBO
Practice Address - Street 2:URB. CANEY
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976-3552
Practice Address - Country:US
Practice Address - Phone:787-755-7845
Practice Address - Fax:787-283-3486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1307300001332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
5965090001Medicare NSC