Provider Demographics
NPI:1760829899
Name:FARMACIA ASTURIAS LLC
Entity Type:Organization
Organization Name:FARMACIA ASTURIAS LLC
Other - Org Name:FARMACIA ASTURIAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARZANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-786-2876
Mailing Address - Street 1:QUINTA DEL RIO
Mailing Address - Street 2:PLAZA 18 J-4
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961
Mailing Address - Country:US
Mailing Address - Phone:787-385-5561
Mailing Address - Fax:
Practice Address - Street 1:AVE. RAMON L. RIVERA, URB. RIVERVIEW
Practice Address - Street 2:BLOQ ZA-6 CALLE 36
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961
Practice Address - Country:US
Practice Address - Phone:787-787-4606
Practice Address - Fax:787-787-4545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-30
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
PR19-F-31203336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2140714OtherPK