Provider Demographics
NPI:1548390511
Name:FARMACIA HOSPITAL MENONITA CAYEY
Entity Type:Organization
Organization Name:FARMACIA HOSPITAL MENONITA CAYEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANEGER
Authorized Official - Prefix:
Authorized Official - First Name:MARTA
Authorized Official - Middle Name:ROSA
Authorized Official - Last Name:MERCADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-535-1001
Mailing Address - Street 1:PO BOX 373130
Mailing Address - Street 2:
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00737
Mailing Address - Country:US
Mailing Address - Phone:787-535-1001
Mailing Address - Fax:
Practice Address - Street 1:BO RINCON INTERIOR CARRETERA NUMERO 14
Practice Address - Street 2:
Practice Address - City:CAYEY PR
Practice Address - State:PR
Practice Address - Zip Code:00737
Practice Address - Country:US
Practice Address - Phone:787-535-1001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOSPITAL MENONITA DE CAYEY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-07
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07-F-12023336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR11-F-2703OtherHEALTH DEPARTMENT