Provider Demographics
NPI:1710922232
Name:FARMACIA BIENESTAR
Entity Type:Organization
Organization Name:FARMACIA BIENESTAR
Other - Org Name:FARMACIA BIENESTAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-855-2300
Mailing Address - Street 1:PO BOX 141492
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614
Mailing Address - Country:US
Mailing Address - Phone:787-855-2300
Mailing Address - Fax:787-855-2301
Practice Address - Street 1:CARR.#2 KM 42.9 BO ALGARROBO
Practice Address - Street 2:
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693
Practice Address - Country:US
Practice Address - Phone:787-855-2300
Practice Address - Fax:787-855-2301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17-F-2762333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2122159OtherPK