Provider Demographics
NPI:1922183706
Name:FARMACIA SAN MARTIN MANATI, INC
Entity Type:Organization
Organization Name:FARMACIA SAN MARTIN MANATI, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:FELIX
Authorized Official - Middle Name:ALI
Authorized Official - Last Name:MALDONADO
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:787-884-4444
Mailing Address - Street 1:54- CARR #2, SUITE #3
Mailing Address - Street 2:PLAZA PUERTA DEL SOL
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674
Mailing Address - Country:US
Mailing Address - Phone:787-884-4444
Mailing Address - Fax:787-884-4444
Practice Address - Street 1:54- CARR #2, SUITE #3
Practice Address - Street 2:PLAZA PUERTA DEL SOL
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-884-4444
Practice Address - Fax:787-884-4444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07-F-08723336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR07-F-0872OtherSTATE REGISTRY
PRDF-01911-7OtherSTATE DRUG REGISTRY
PRDF-01911-7OtherSTATE DRUG REGISTRY