Provider Demographics
NPI:1467460642
Name:FARMACIA PEPINO, INC.
Entity type:Organization
Organization Name:FARMACIA PEPINO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:I
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:787-234-5323
Mailing Address - Street 1:AVE EMERITO ESTRADA # 1001
Mailing Address - Street 2:
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685-3008
Mailing Address - Country:US
Mailing Address - Phone:787-896-3090
Mailing Address - Fax:787-280-9456
Practice Address - Street 1:AVE EMERITO ESTRADA # 1001
Practice Address - Street 2:
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685-3008
Practice Address - Country:US
Practice Address - Phone:787-896-3090
Practice Address - Fax:787-280-9456
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FARMACIA PEPINO, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-04
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR038068100Medicaid