Provider Demographics
NPI:1689722647
Name:FARMACIA AMIGA INC
Entity Type:Organization
Organization Name:FARMACIA AMIGA INC
Other - Org Name:FARMACIA AMIGA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:
Authorized Official - Last Name:CABAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-752-6246
Mailing Address - Street 1:CEN COM MONSERRATE PLAZA, AVE PASEO DE LOS GIGANTES
Mailing Address - Street 2:VILLA CAROLINA
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00985-5444
Mailing Address - Country:US
Mailing Address - Phone:787-752-6246
Mailing Address - Fax:787-762-4070
Practice Address - Street 1:CEN COM MONSERRATE PLAZA, AVE PASEO DE LOS GIGANTES
Practice Address - Street 2:VILLA CAROLINA
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985-5444
Practice Address - Country:US
Practice Address - Phone:787-752-6246
Practice Address - Fax:787-762-4070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
PR19-F-04783336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2084384OtherPK
2084384OtherPK