Provider Demographics
NPI:1295833234
Name:ENID FARMACIA SANTA ANA DE PATILLAS INC
Entity Type:Organization
Organization Name:ENID FARMACIA SANTA ANA DE PATILLAS INC
Other - Org Name:FARMACIA SANTA ANA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ENID
Authorized Official - Middle Name:
Authorized Official - Last Name:RIEFKOHL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:787-839-8025
Mailing Address - Street 1:PO BOX 925
Mailing Address - Street 2:
Mailing Address - City:PATILLAS
Mailing Address - State:PR
Mailing Address - Zip Code:00723-0925
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:C/G RIEFKOHL #8
Practice Address - Street 2:
Practice Address - City:PATILLAS
Practice Address - State:PR
Practice Address - Zip Code:00723
Practice Address - Country:US
Practice Address - Phone:787-839-5025
Practice Address - Fax:787-839-3219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
PR18F30173336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2084974OtherPK