Provider Demographics
NPI:1952819153
Name:PRO FPS GROUP CORPORATION
Entity Type:Organization
Organization Name:PRO FPS GROUP CORPORATION
Other - Org Name:FARMACIA PROSALUD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MILTON
Authorized Official - Middle Name:
Authorized Official - Last Name:LUGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-207-8586
Mailing Address - Street 1:PO BOX 1411
Mailing Address - Street 2:
Mailing Address - City:LAJAS
Mailing Address - State:PR
Mailing Address - Zip Code:00667-1411
Mailing Address - Country:US
Mailing Address - Phone:787-821-1267
Mailing Address - Fax:787-821-1474
Practice Address - Street 1:CARR 116 RAMAL 1116
Practice Address - Street 2:KM 27.7
Practice Address - City:GUANICA
Practice Address - State:PR
Practice Address - Zip Code:00653-2105
Practice Address - Country:US
Practice Address - Phone:787-821-1267
Practice Address - Fax:787-821-1474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-22
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
PR20-F-35333336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2175725OtherPK