Provider Demographics
NPI:1326145848
Name:SANTIAGO R VARELA
Entity Type:Organization
Organization Name:SANTIAGO R VARELA
Other - Org Name:FARMACIA BRAU
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SANTIAGO
Authorized Official - Middle Name:R
Authorized Official - Last Name:VARELA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-826-4120
Mailing Address - Street 1:PO BOX 144
Mailing Address - Street 2:CALLE SAN ANTONIO #17
Mailing Address - City:ANASCO
Mailing Address - State:PR
Mailing Address - Zip Code:00610-0144
Mailing Address - Country:US
Mailing Address - Phone:787-826-4400
Mailing Address - Fax:787-826-6738
Practice Address - Street 1:CALLE SAN ANTONIO #17
Practice Address - Street 2:
Practice Address - City:ANASCO
Practice Address - State:PR
Practice Address - Zip Code:00610
Practice Address - Country:US
Practice Address - Phone:787-826-4120
Practice Address - Fax:787-826-6738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-19
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1314290002332B00000X
PR07-F-12873336C0003X
PR07F12873336C0004X, 3336H0001X, 3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1314290002Medicare NSC