Provider Demographics
NPI:1730112004
Name:FARMACIA SAN JOSE DE JUNCOS, CORP
Entity Type:Organization
Organization Name:FARMACIA SAN JOSE DE JUNCOS, CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DELGADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-734-2039
Mailing Address - Street 1:58 CALLE ALGARIN
Mailing Address - Street 2:
Mailing Address - City:JUNCOS
Mailing Address - State:PR
Mailing Address - Zip Code:00777
Mailing Address - Country:US
Mailing Address - Phone:787-734-2039
Mailing Address - Fax:787-734-3839
Practice Address - Street 1:58 CALLE ALGARIN
Practice Address - Street 2:
Practice Address - City:JUNCOS
Practice Address - State:PR
Practice Address - Zip Code:00777-3514
Practice Address - Country:US
Practice Address - Phone:787-734-2039
Practice Address - Fax:787-734-3839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR003087183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR5131000001Medicare ID - Type UnspecifiedPHARMACY