Provider Demographics
NPI:1578058467
Name:FRANQUISIEROS O, INC.
Entity Type:Organization
Organization Name:FRANQUISIEROS O, INC.
Other - Org Name:MOCA EXPRESS PHARMACY
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-877-2216
Mailing Address - Street 1:PO BOX 4253
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00605-4253
Mailing Address - Country:US
Mailing Address - Phone:787-877-2216
Mailing Address - Fax:787-877-2280
Practice Address - Street 1:CARR 111 KM 4.5
Practice Address - Street 2:AVE LA MOCA 202
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00676
Practice Address - Country:US
Practice Address - Phone:787-877-2216
Practice Address - Fax:787-877-2280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-25
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR20-F-3552333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy