Provider Demographics
NPI:1568679025
Name:FARMACIA PENA INC.
Entity Type:Organization
Organization Name:FARMACIA PENA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:ARTURO
Authorized Official - Last Name:PENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-842-9182
Mailing Address - Street 1:110 CALLE VICTORIA
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00730-3691
Mailing Address - Country:US
Mailing Address - Phone:787-842-9182
Mailing Address - Fax:787-842-9182
Practice Address - Street 1:110 CALLE VICTORIA
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00730-3691
Practice Address - Country:US
Practice Address - Phone:787-842-9182
Practice Address - Fax:787-842-9182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR09-F-02483336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy