Provider Demographics
NPI:1821153339
Name:NUESTRA FARMACIA SAN FRANCISCO LLC
Entity Type:Organization
Organization Name:NUESTRA FARMACIA SAN FRANCISCO LLC
Other - Org Name:NUESTRA FARMACIA SAN FRANCISCO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:RUIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-473-2247
Mailing Address - Street 1:166 CALLE COLON
Mailing Address - Street 2:
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602-3222
Mailing Address - Country:US
Mailing Address - Phone:787-868-4940
Mailing Address - Fax:787-868-4940
Practice Address - Street 1:166 CALLE COLON
Practice Address - Street 2:
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602-3222
Practice Address - Country:US
Practice Address - Phone:787-868-4940
Practice Address - Fax:787-868-4940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18F32273336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2149874OtherPK