Provider Demographics
NPI:1376620872
Name:FARMACIA JARDINES DEL CARIBE
Entity Type:Organization
Organization Name:FARMACIA JARDINES DEL CARIBE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GUILLERMO
Authorized Official - Middle Name:
Authorized Official - Last Name:ECHEVARRIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-843-8023
Mailing Address - Street 1:111 CALLE 17
Mailing Address - Street 2:URB. JARDINES DEL CARIBE
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00728-4448
Mailing Address - Country:US
Mailing Address - Phone:787-843-8023
Mailing Address - Fax:
Practice Address - Street 1:111 CALLE 17
Practice Address - Street 2:URB. JARDINES DEL CARIBE
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00728-4448
Practice Address - Country:US
Practice Address - Phone:787-843-8023
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07-F-10423336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy