Provider Demographics
NPI:1346360419
Name:FARMACIA VILLA REAL
Entity Type:Organization
Organization Name:FARMACIA VILLA REAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:M
Authorized Official - Last Name:CANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-858-1336
Mailing Address - Street 1:PO BOX 282
Mailing Address - Street 2:
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00694-0282
Mailing Address - Country:US
Mailing Address - Phone:787-858-1336
Mailing Address - Fax:787-858-1336
Practice Address - Street 1:C2 CALLE 2
Practice Address - Street 2:VILLA REAL
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693-3804
Practice Address - Country:US
Practice Address - Phone:787-858-1336
Practice Address - Fax:787-858-1336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07F11833336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy