Provider Demographics
NPI:1851472229
Name:FARWIACIA GENERILA RAWALLOSA
Entity Type:Organization
Organization Name:FARWIACIA GENERILA RAWALLOSA
Other - Org Name:FARMACIA GENERICA RAMALLOSA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ REYES
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:787-732-7900
Mailing Address - Street 1:PO BOX 270
Mailing Address - Street 2:
Mailing Address - City:AGUAS BUENAS
Mailing Address - State:PR
Mailing Address - Zip Code:00703-0270
Mailing Address - Country:US
Mailing Address - Phone:787-732-7900
Mailing Address - Fax:787-732-6658
Practice Address - Street 1:BARRIO MULAS CARR. 174 KM 21.1
Practice Address - Street 2:
Practice Address - City:AGUAS BUENAS
Practice Address - State:PR
Practice Address - Zip Code:00703
Practice Address - Country:US
Practice Address - Phone:787-732-7900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRHDS-MEDEOther610500
PRMC-21 HUMANAOther010868
PRLILLYOther600428
PRPAIDOther610014
PRPCSOther610415
PRARGUSOther610649
PRPCS - 2Other012114
PRPFIZER FOR LIVINGOther600428
PRECKERD HEALTHOther610474
PRMAX ASSISTANCEOther010595
PRMCS-2Other012114
PRTRICAREOther003858
PRSSS-MEDICAREOther010868
PRWHP NEWOther603286
PRMCS PUERTO RICOOther610029
PRPICAOther610674
PRADVANCE PCSOther004336
PRDYNO NOBELOther003858
PRMPBOther010868