Provider Demographics
NPI:1871668160
Name:FARMACIA GLAMAR
Entity Type:Organization
Organization Name:FARMACIA GLAMAR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST , OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GLADYS
Authorized Official - Middle Name:
Authorized Official - Last Name:MARRERO
Authorized Official - Suffix:
Authorized Official - Credentials:LCDA
Authorized Official - Phone:787-871-4170
Mailing Address - Street 1:18 CALLE PALMER
Mailing Address - Street 2:
Mailing Address - City:CIALES
Mailing Address - State:PR
Mailing Address - Zip Code:00638-3246
Mailing Address - Country:US
Mailing Address - Phone:787-871-4170
Mailing Address - Fax:787-871-2322
Practice Address - Street 1:18 CALLE PALMER
Practice Address - Street 2:
Practice Address - City:CIALES
Practice Address - State:PR
Practice Address - Zip Code:00638-3246
Practice Address - Country:US
Practice Address - Phone:787-871-4170
Practice Address - Fax:787-871-2322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07-F-00573336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR07-F-0057OtherHEALTH DEPARTMENT
PR40003339OtherNABP
PR07-F-0057OtherHEALTH DEPARTMENT