Provider Demographics
NPI:1609823269
Name:CENTRAL DRUG JM CO. INC.
Entity Type:Organization
Organization Name:CENTRAL DRUG JM CO. INC.
Other - Org Name:FARMACIA CENTRAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSSUE
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:GALGUERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-783-9855
Mailing Address - Street 1:AVE JESUS T PINERO 1304
Mailing Address - Street 2:CAPARRA TERR
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921-1508
Mailing Address - Country:US
Mailing Address - Phone:787-783-9855
Mailing Address - Fax:787-782-7995
Practice Address - Street 1:AVE JESUS T PINERO 1304
Practice Address - Street 2:CAPARRA TERR
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-1508
Practice Address - Country:US
Practice Address - Phone:787-783-9855
Practice Address - Fax:787-782-7995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1153160001333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1153160001Medicare NSC