Provider Demographics
NPI:1811038417
Name:SUPER FARMACIA SANTA MONICA
Entity Type:Organization
Organization Name:SUPER FARMACIA SANTA MONICA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYNETTE
Authorized Official - Middle Name:O
Authorized Official - Last Name:FIGUEROA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:787-786-0455
Mailing Address - Street 1:A17 CALLE 13
Mailing Address - Street 2:SANTA MONICA
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00957-1807
Mailing Address - Country:US
Mailing Address - Phone:787-786-0455
Mailing Address - Fax:
Practice Address - Street 1:A17 CALLE 13
Practice Address - Street 2:SANTA MONICA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00957-1807
Practice Address - Country:US
Practice Address - Phone:787-786-0455
Practice Address - Fax:787-787-4502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07F08593336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy