Provider Demographics
NPI:1619417326
Name:FARMACIA YANIZ L.L.C.
Entity Type:Organization
Organization Name:FARMACIA YANIZ L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MINALIS
Authorized Official - Middle Name:
Authorized Official - Last Name:PANTOJAS
Authorized Official - Suffix:
Authorized Official - Credentials:PROPIETARY
Authorized Official - Phone:787-693-0302
Mailing Address - Street 1:PO BOX 5034
Mailing Address - Street 2:BO MARICAO
Mailing Address - City:VEGA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00692-5034
Mailing Address - Country:US
Mailing Address - Phone:787-693-0302
Mailing Address - Fax:787-693-0302
Practice Address - Street 1:CARR 164 # KM142
Practice Address - Street 2:BO PALMAREJO
Practice Address - City:COROZAL
Practice Address - State:PR
Practice Address - Zip Code:00783-2400
Practice Address - Country:US
Practice Address - Phone:787-693-0302
Practice Address - Fax:787-693-0302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19-F-34693336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy