Provider Demographics
NPI:1346381712
Name:FARMACIA BORINQUEN, L.L.C
Entity Type:Organization
Organization Name:FARMACIA BORINQUEN, L.L.C
Other - Org Name:FARMACIA BORINQUEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:
Authorized Official - Last Name:VARELA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:939-640-6750
Mailing Address - Street 1:PO BOX 250489
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00604-0489
Mailing Address - Country:US
Mailing Address - Phone:787-891-5479
Mailing Address - Fax:787-882-1535
Practice Address - Street 1:CARRETERA 107 KM 3.5 BO BORINQUEN
Practice Address - Street 2:
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:787-891-5479
Practice Address - Fax:787-882-1535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0003X
PR18-F-22553336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2086080OtherPK
2086080OtherPK