Provider Demographics
NPI:1447398847
Name:TU FARMACIA FAMILIAR LILLY INC
Entity Type:Organization
Organization Name:TU FARMACIA FAMILIAR LILLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LILLIAN
Authorized Official - Middle Name:T
Authorized Official - Last Name:MARRERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-861-4855
Mailing Address - Street 1:BOX 66
Mailing Address - Street 2:
Mailing Address - City:MAUNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00707
Mailing Address - Country:US
Mailing Address - Phone:787-861-4855
Mailing Address - Fax:787-861-1056
Practice Address - Street 1:BARCELO STREET 17
Practice Address - Street 2:
Practice Address - City:MAUNABO
Practice Address - State:PR
Practice Address - Zip Code:00707
Practice Address - Country:US
Practice Address - Phone:787-861-4855
Practice Address - Fax:787-861-1056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07F1864333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4019243Medicare UPIN