Provider Demographics
NPI:1518028232
Name:FARMACIA QUESADA INC.
Entity Type:Organization
Organization Name:FARMACIA QUESADA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MERINELDA
Authorized Official - Middle Name:
Authorized Official - Last Name:QUESADA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-821-3065
Mailing Address - Street 1:PO BOX 488
Mailing Address - Street 2:
Mailing Address - City:GUANICA
Mailing Address - State:PR
Mailing Address - Zip Code:00653-0488
Mailing Address - Country:US
Mailing Address - Phone:787-821-3065
Mailing Address - Fax:
Practice Address - Street 1:75 CALLE 25 DE JULIO
Practice Address - Street 2:
Practice Address - City:GUANICA
Practice Address - State:PR
Practice Address - Zip Code:00653-2804
Practice Address - Country:US
Practice Address - Phone:787-821-3065
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07-F-1071183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR648811001Medicare PIN