Provider Demographics
NPI:1477696516
Name:FARMACIA CUPEY GARDENS
Entity Type:Organization
Organization Name:FARMACIA CUPEY GARDENS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:EDGARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-761-1212
Mailing Address - Street 1:CUPEY GARDENS AVE. CUPEY GARDENS
Mailing Address - Street 2:PLAZA STE. 1E
Mailing Address - City:RIO PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-761-1212
Mailing Address - Fax:787-761-1255
Practice Address - Street 1:200 AVE CUPEY GDNS
Practice Address - Street 2:PLAZA STE. 1E
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00926-7341
Practice Address - Country:US
Practice Address - Phone:787-761-1212
Practice Address - Fax:787-761-1255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07F1735333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy