Provider Demographics
NPI:1558585695
Name:FARMACIA EL PALMAR, INC.
Entity Type:Organization
Organization Name:FARMACIA EL PALMAR, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND FARMACEUTICA
Authorized Official - Prefix:MS
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MORO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-310-4085
Mailing Address - Street 1:PO BOX 658
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676
Mailing Address - Country:US
Mailing Address - Phone:787-891-9158
Mailing Address - Fax:787-252-2529
Practice Address - Street 1:CARRETERA 111 KM 1 8
Practice Address - Street 2:BARRIO PALMAR
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:787-891-9158
Practice Address - Fax:787-252-2529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR09-F-17243336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
447623001Medicare ID - Type Unspecified