Provider Demographics
NPI:1811020019
Name:FFARMACIA FLAMINGO, INC.
Entity Type:Organization
Organization Name:FFARMACIA FLAMINGO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:MISS
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:ESTHER
Authorized Official - Last Name:RIERA
Authorized Official - Suffix:
Authorized Official - Credentials:4741215 LIC CONDUCI
Authorized Official - Phone:787-780-3005
Mailing Address - Street 1:C11 CALLE BB
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00957-1777
Mailing Address - Country:US
Mailing Address - Phone:787-780-3005
Mailing Address - Fax:787-778-8034
Practice Address - Street 1:C11 CALLE BB
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00957-1777
Practice Address - Country:US
Practice Address - Phone:787-780-3005
Practice Address - Fax:787-778-8034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR09-F-20793336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4669450001Medicare ID - Type Unspecified