Provider Demographics
NPI:1619091303
Name:PHARMACARE, INC.
Entity Type:Organization
Organization Name:PHARMACARE, INC.
Other - Org Name:FARMACIA REY #24
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:REYNOSO CABRERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-692-2449
Mailing Address - Street 1:PO BOX 260310
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-2621
Mailing Address - Country:US
Mailing Address - Phone:787-692-2449
Mailing Address - Fax:787-287-7800
Practice Address - Street 1:CARR. 156 KM. 13.4 BO. PALO HINCADO
Practice Address - Street 2:
Practice Address - City:BARRANQUITAS
Practice Address - State:PR
Practice Address - Zip Code:00794
Practice Address - Country:US
Practice Address - Phone:787-857-3980
Practice Address - Fax:787-857-4280
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHARMACARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-19
Last Update Date:2019-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR09F2004183500000X
PR19-F-35253336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR5702640001Medicare NSC