Provider Demographics
NPI:1629132782
Name:FARMACIA LA FE # 3
Entity Type:Organization
Organization Name:FARMACIA LA FE # 3
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:MR
Authorized Official - First Name:KERMIT
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:787-845-6695
Mailing Address - Street 1:CARR 153 KM 2.2 BO FELICIA II
Mailing Address - Street 2:DENTRO PONCE CASH & CARRY
Mailing Address - City:SANTA ISABEL
Mailing Address - State:PR
Mailing Address - Zip Code:00757
Mailing Address - Country:US
Mailing Address - Phone:787-845-6695
Mailing Address - Fax:787-845-5428
Practice Address - Street 1:CARR 153 KM 2.2 BO FELICIA II
Practice Address - Street 2:DENTRO PONCE CASH & CARRY
Practice Address - City:SANTA ISABEL
Practice Address - State:PR
Practice Address - Zip Code:00757
Practice Address - Country:US
Practice Address - Phone:787-845-6695
Practice Address - Fax:787-845-5428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2009-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07F1778183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4022872OtherNCPDP