Provider Demographics
NPI:1750464053
Name:KIRIE ENTERPRISES
Entity Type:Organization
Organization Name:KIRIE ENTERPRISES
Other - Org Name:FARMACIA KIRIE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-768-4366
Mailing Address - Street 1:PO BOX 29775
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00929-0775
Mailing Address - Country:US
Mailing Address - Phone:787-768-4366
Mailing Address - Fax:
Practice Address - Street 1:PLAZA 66 CARR 848 KM 4.2 ESQ. FLORENTINO ROMAN
Practice Address - Street 2:BO. SAN ANTON
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983
Practice Address - Country:US
Practice Address - Phone:787-768-4366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR08F2367183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4025260OtherNCPDP
PR08F2367OtherLICENCIA ESTATAL