Provider Demographics
NPI:1851624829
Name:DESARROLLADORA COMERCIAL INC
Entity Type:Organization
Organization Name:DESARROLLADORA COMERCIAL INC
Other - Org Name:FARMACIA MARIFE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARILIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BENNAZAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-444-2365
Mailing Address - Street 1:PO BOX 1
Mailing Address - Street 2:
Mailing Address - City:AGUIRRE
Mailing Address - State:PR
Mailing Address - Zip Code:00704-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:233 CALLE SANTA ANA # A
Practice Address - Street 2:BO COCO NUEVO
Practice Address - City:SALINAS
Practice Address - State:PR
Practice Address - Zip Code:00751-2625
Practice Address - Country:US
Practice Address - Phone:787-824-2617
Practice Address - Fax:787-824-6797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-09
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11-F-2747333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4026945OtherNCPDP PROVIDER IDENTIFICATION NUMBER