Provider Demographics
NPI:1306193453
Name:FARMA DISTRIBUTORS INC
Entity Type:Organization
Organization Name:FARMA DISTRIBUTORS INC
Other - Org Name:FARMARKET BELLA VISTA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARIO CORPORATIVO
Authorized Official - Prefix:MR
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:L
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-797-2709
Mailing Address - Street 1:1 BELLA VISTA COMMERCIAL CTR
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00957-6051
Mailing Address - Country:US
Mailing Address - Phone:787-797-2709
Mailing Address - Fax:787-730-2255
Practice Address - Street 1:1 BELLA VISTA COMMERCIAL CTR
Practice Address - Street 2:SUITE 1A
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00957-6051
Practice Address - Country:US
Practice Address - Phone:787-797-2709
Practice Address - Fax:787-730-2255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-08
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12-F-2348302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization