Provider Demographics
NPI:1699838482
Name:RICARDO RIVERA CRUZ
Entity Type:Organization
Organization Name:RICARDO RIVERA CRUZ
Other - Org Name:FARMACIA LA SALUD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:R PH
Authorized Official - Phone:787-832-6355
Mailing Address - Street 1:250 CALLE SAN IGNACIO
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680-4625
Mailing Address - Country:US
Mailing Address - Phone:787-832-6355
Mailing Address - Fax:787-833-8872
Practice Address - Street 1:250 CALLE SAN IGNACIO
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-4625
Practice Address - Country:US
Practice Address - Phone:787-832-6355
Practice Address - Fax:787-833-8872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07-F-00603336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4015714OtherNCPDP