Provider Demographics
NPI:1871649616
Name:JOSE PEREZ FONSECA INC.
Entity Type:Organization
Organization Name:JOSE PEREZ FONSECA INC.
Other - Org Name:FARMACIAS PLAZA 7
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RIGEL
Authorized Official - Middle Name:UBEC
Authorized Official - Last Name:BEAUCHAMP
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:787-620-9600
Mailing Address - Street 1:PO BOX 246
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-0246
Mailing Address - Country:US
Mailing Address - Phone:787-620-9600
Mailing Address - Fax:787-740-3666
Practice Address - Street 1:11 CALLE DEGETAU
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6312
Practice Address - Country:US
Practice Address - Phone:787-620-9607
Practice Address - Fax:787-786-4564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07F09173336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy