Provider Demographics
NPI:1457487159
Name:RECETA A SU PUERTA INC
Entity Type:Organization
Organization Name:RECETA A SU PUERTA INC
Other - Org Name:FARMACIA CAPETILLO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PIC / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MIRTA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-765-1211
Mailing Address - Street 1:251 CALLE ROBLE
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00925-3104
Mailing Address - Country:US
Mailing Address - Phone:787-765-1211
Mailing Address - Fax:787-765-1576
Practice Address - Street 1:251 CALLE ROBLE
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00925-3104
Practice Address - Country:US
Practice Address - Phone:787-751-6312
Practice Address - Fax:787-250-8661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18-F-25943336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2129754OtherPK