Provider Demographics
NPI:1932300720
Name:FARMACIA BELMONTE, INC.
Entity Type:Organization
Organization Name:FARMACIA BELMONTE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:787-849-4173
Mailing Address - Street 1:PO BOX 1085
Mailing Address - Street 2:
Mailing Address - City:HORMIGUEROS
Mailing Address - State:PR
Mailing Address - Zip Code:00660-1085
Mailing Address - Country:US
Mailing Address - Phone:787-849-4173
Mailing Address - Fax:787-849-4176
Practice Address - Street 1:345 CALLE POST S
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-2389
Practice Address - Country:US
Practice Address - Phone:787-831-2212
Practice Address - Fax:787-805-3875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR09-F-1452332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4112690004Medicare ID - Type Unspecified