Provider Demographics
NPI:1891902094
Name:FARMACIA DEL PUEBLO I-JUNCOS
Entity Type:Organization
Organization Name:FARMACIA DEL PUEBLO I-JUNCOS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TECNICO DE FARMACIA
Authorized Official - Prefix:MRS
Authorized Official - First Name:RIVERA
Authorized Official - Middle Name:CASTRO
Authorized Official - Last Name:BRENDA LIZ
Authorized Official - Suffix:
Authorized Official - Credentials:FARMACEUTICO
Authorized Official - Phone:787-734-3081
Mailing Address - Street 1:PARCELAS LAS CUATROCIENTAS
Mailing Address - Street 2:HC-03 BOX 8210
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729-0000
Mailing Address - Country:US
Mailing Address - Phone:787-736-3143
Mailing Address - Fax:787-734-6767
Practice Address - Street 1:CALLE #10 CASA 102
Practice Address - Street 2:PARCELAS DE VALENCIANO BO. VALENCIANO ABAJO
Practice Address - City:JUNCOS
Practice Address - State:PR
Practice Address - Zip Code:00777-0000
Practice Address - Country:US
Practice Address - Phone:787-736-3143
Practice Address - Fax:787-734-6767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR003523251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health