Provider Demographics
NPI:1851428502
Name:FARMACIA SANTA CRUZ
Entity Type:Organization
Organization Name:FARMACIA SANTA CRUZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NORBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:ROLON
Authorized Official - Suffix:
Authorized Official - Credentials:PH
Authorized Official - Phone:787-798-4646
Mailing Address - Street 1:PO BOX 101
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-0101
Mailing Address - Country:US
Mailing Address - Phone:787-798-4646
Mailing Address - Fax:787-288-8111
Practice Address - Street 1:73 CALLE SANTA CRUZ STE 101
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6911
Practice Address - Country:US
Practice Address - Phone:787-798-4646
Practice Address - Fax:787-288-8111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2037183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty