Provider Demographics
NPI:1346222866
Name:FARMACIA AMERICANA INC
Entity Type:Organization
Organization Name:FARMACIA AMERICANA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:M
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PH
Authorized Official - Phone:787-728-6095
Mailing Address - Street 1:PO BOX 6116
Mailing Address - Street 2:LOIZA STATION
Mailing Address - City:SANTURCE
Mailing Address - State:PR
Mailing Address - Zip Code:00914-6116
Mailing Address - Country:US
Mailing Address - Phone:787-728-6095
Mailing Address - Fax:787-268-5102
Practice Address - Street 1:1854 CALLE LOIZA
Practice Address - Street 2:
Practice Address - City:SANTURCE
Practice Address - State:PR
Practice Address - Zip Code:00911-1824
Practice Address - Country:US
Practice Address - Phone:787-728-6095
Practice Address - Fax:787-268-5102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
07F0291333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR3895980001Medicare ID - Type Unspecified