Provider Demographics
NPI:1568835395
Name:OPTIFARMA LLC
Entity Type:Organization
Organization Name:OPTIFARMA LLC
Other - Org Name:FARMACIA OPTIFARMA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:YIOVANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALMODOVAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-841-4539
Mailing Address - Street 1:1232 AVE MUNOZ RIVERA
Mailing Address - Street 2:REPTO UNIVERSITARIO
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717-0639
Mailing Address - Country:US
Mailing Address - Phone:787-841-4539
Mailing Address - Fax:787-841-2659
Practice Address - Street 1:1232 AVE MUNOZ RIVERA
Practice Address - Street 2:REPTO UNIVERSITARIO
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-0639
Practice Address - Country:US
Practice Address - Phone:787-841-4539
Practice Address - Fax:787-841-2659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-02
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
PR17-F-33343336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2158469OtherPK