Provider Demographics
NPI:1861680472
Name:BRICEIDA HERNANDEZ
Entity Type:Organization
Organization Name:BRICEIDA HERNANDEZ
Other - Org Name:FARMACIA TANON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BRICEIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:787-779-6173
Mailing Address - Street 1:AVE NOGAL IL 26 ROYAL PALM
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956
Mailing Address - Country:US
Mailing Address - Phone:787-779-6173
Mailing Address - Fax:787-779-6173
Practice Address - Street 1:AVE NOGAL IL 26
Practice Address - Street 2:ROYAL PALM
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956
Practice Address - Country:US
Practice Address - Phone:787-779-6173
Practice Address - Fax:787-779-6173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy