Provider Demographics
NPI:1891836623
Name:FARMACIA DENIRKA
Entity Type:Organization
Organization Name:FARMACIA DENIRKA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GIL
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:NIEVES
Authorized Official - Suffix:
Authorized Official - Credentials:PH D
Authorized Official - Phone:787-863-7788
Mailing Address - Street 1:AVE GENERAL VALERO #305
Mailing Address - Street 2:
Mailing Address - City:FAJARDO
Mailing Address - State:PR
Mailing Address - Zip Code:00738
Mailing Address - Country:US
Mailing Address - Phone:787-863-7788
Mailing Address - Fax:787-863-1422
Practice Address - Street 1:AVE. GENERAL VALERO # 305
Practice Address - Street 2:
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738
Practice Address - Country:US
Practice Address - Phone:787-863-7788
Practice Address - Fax:787-863-1422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07-F-03663336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRDF-01380-5OtherASSMCA
PRDF-01380-5OtherASSMCA