Provider Demographics
NPI:1629147368
Name:MARIBEL ALONSO GONZALEZ / FARMACIA GLORIEL
Entity Type:Organization
Organization Name:MARIBEL ALONSO GONZALEZ / FARMACIA GLORIEL
Other - Org Name:FARMACIA GLORIEL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIBEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ALONSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-832-2432
Mailing Address - Street 1:50 N CALLE
Mailing Address - Street 2:RAMON EMETERIO BETANCES
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680
Mailing Address - Country:US
Mailing Address - Phone:787-832-2432
Mailing Address - Fax:787-805-6920
Practice Address - Street 1:50 N CALLE
Practice Address - Street 2:RAMON EMETERIO BETANCES
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-832-2432
Practice Address - Fax:787-805-6920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
PR17F19353336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2085732OtherPK
PR1282010001Medicare NSC