Provider Demographics
NPI:1659742138
Name:FARMACIA JUNCAL
Entity Type:Organization
Organization Name:FARMACIA JUNCAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYMARIS
Authorized Official - Middle Name:E
Authorized Official - Last Name:MENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:787-486-3521
Mailing Address - Street 1:CALLE BARBOSA 212
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00676
Mailing Address - Country:UM
Mailing Address - Phone:787-486-3521
Mailing Address - Fax:
Practice Address - Street 1:CARR 111 KM 30.8
Practice Address - Street 2:BO JUNCAL
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685
Practice Address - Country:US
Practice Address - Phone:787-486-3521
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-09
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR3336C0003XOtherTAXONOMY