Provider Demographics
NPI:1689788663
Name:FARMA DISTRIBUTORS INC
Entity Type:Organization
Organization Name:FARMA DISTRIBUTORS INC
Other - Org Name:FARMARKET BELLA VISTA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAVIER
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-797-2709
Mailing Address - Street 1:EDIFICIO 1 LOCAL 1A
Mailing Address - Street 2:COMERCIAL BELLA VISTA
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00957
Mailing Address - Country:US
Mailing Address - Phone:787-797-2709
Mailing Address - Fax:787-730-2255
Practice Address - Street 1:EDIFICIO 1 LOCAL 1A
Practice Address - Street 2:COMERCIAL BELLA VISTA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00957
Practice Address - Country:US
Practice Address - Phone:787-797-2709
Practice Address - Fax:787-730-2255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
PR16F23483336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2084599OtherPK
2084599OtherPK