Provider Demographics
NPI:1801205125
Name:J.I.L. PHARMACY CARE INC.
Entity Type:Organization
Organization Name:J.I.L. PHARMACY CARE INC.
Other - Org Name:FARMACIA SAN MIGUEL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT SECRETARY/PARMACY
Authorized Official - Prefix:
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-863-1870
Mailing Address - Street 1:PO BOX 1022
Mailing Address - Street 2:
Mailing Address - City:FAJARDO
Mailing Address - State:PR
Mailing Address - Zip Code:00738-1022
Mailing Address - Country:US
Mailing Address - Phone:787-863-1870
Mailing Address - Fax:787-655-9539
Practice Address - Street 1:54 CALLE DR LOPEZ W
Practice Address - Street 2:
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738-4635
Practice Address - Country:US
Practice Address - Phone:787-863-1870
Practice Address - Fax:787-655-9539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-12
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
PR16F31923336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2147212OtherPK