Provider Demographics
NPI:1467583856
Name:FARMACIA HOSPITAL DEL MAESTRO
Entity Type:Organization
Organization Name:FARMACIA HOSPITAL DEL MAESTRO
Other - Org Name:ASOCIACION HOSPITAL DEL MAESTRO, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MILAGROS
Authorized Official - Middle Name:A
Authorized Official - Last Name:ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-758-8383
Mailing Address - Street 1:PO BOX 364708
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-4708
Mailing Address - Country:US
Mailing Address - Phone:787-758-8383
Mailing Address - Fax:787-294-3103
Practice Address - Street 1:550 SERGIO CUEVAS BUSTAMANTE
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-758-8383
Practice Address - Fax:787-294-3103
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOSPITAL DEL MAESTRO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-08
Last Update Date:2015-02-20
Deactivation Date:2014-12-02
Deactivation Code:
Reactivation Date:2015-01-28
Provider Licenses
StateLicense IDTaxonomies
PR07-F-0672333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy