Provider Demographics
NPI:1528595568
Name:FARMACIA MORALES EGIPCIACO
Entity Type:Organization
Organization Name:FARMACIA MORALES EGIPCIACO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:IVELISSE
Authorized Official - Last Name:BADILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-390-6041
Mailing Address - Street 1:PO BOX 223
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-0223
Mailing Address - Country:US
Mailing Address - Phone:787-390-6041
Mailing Address - Fax:787-877-3680
Practice Address - Street 1:72 CALLE DON CHEMARY
Practice Address - Street 2:
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676-4122
Practice Address - Country:US
Practice Address - Phone:787-877-3680
Practice Address - Fax:787-877-3680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-22
Last Update Date:2017-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy