Provider Demographics
NPI:1437257110
Name:VIRGILIO CRUZ RIVERA
Entity Type:Organization
Organization Name:VIRGILIO CRUZ RIVERA
Other - Org Name:FARMACIA DEL PILAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VIRGILLO
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-734-2186
Mailing Address - Street 1:PO BOX 1770
Mailing Address - Street 2:
Mailing Address - City:JUNCOS
Mailing Address - State:PR
Mailing Address - Zip Code:00777-1770
Mailing Address - Country:US
Mailing Address - Phone:787-734-2186
Mailing Address - Fax:787-734-2186
Practice Address - Street 1:CALLE TEODOMIRO DELFAU
Practice Address - Street 2:STE 26
Practice Address - City:JUNCOS
Practice Address - State:PR
Practice Address - Zip Code:00777
Practice Address - Country:US
Practice Address - Phone:787-734-2186
Practice Address - Fax:787-734-2186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
PR11F13343336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4012326OtherNCPDP PROVIDER IDENTIFICATION NUMBER