Provider Demographics
NPI:1871629550
Name:CORPORACION FLORES RIVERA
Entity Type:Organization
Organization Name:CORPORACION FLORES RIVERA
Other - Org Name:MI FARMACIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FLORES
Authorized Official - Middle Name:H
Authorized Official - Last Name:JOSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-869-1404
Mailing Address - Street 1:HC 1 BOX 5393
Mailing Address - Street 2:
Mailing Address - City:BARRANQUITAS
Mailing Address - State:PR
Mailing Address - Zip Code:00794-9692
Mailing Address - Country:US
Mailing Address - Phone:787-869-1404
Mailing Address - Fax:787-227-4557
Practice Address - Street 1:ST. 152 CEDRO ARRIBA
Practice Address - Street 2:KM 9.9
Practice Address - City:NARANJITO
Practice Address - State:PR
Practice Address - Zip Code:00719
Practice Address - Country:US
Practice Address - Phone:787-869-1604
Practice Address - Fax:787-227-4557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07-F-21613336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRBM8676554OtherDEA LICENCE