Provider Demographics
NPI:1992858963
Name:ALTERNATIVE PHARMACY INC
Entity Type:Organization
Organization Name:ALTERNATIVE PHARMACY INC
Other - Org Name:FARMACIA SAN ANTONIO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:EDGARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:AREIZAGA
Authorized Official - Suffix:
Authorized Official - Credentials:CPA ESQ
Authorized Official - Phone:787-502-1428
Mailing Address - Street 1:PO BOX 224
Mailing Address - Street 2:
Mailing Address - City:AGUAS BUENAS
Mailing Address - State:PR
Mailing Address - Zip Code:00703-0224
Mailing Address - Country:US
Mailing Address - Phone:787-732-3131
Mailing Address - Fax:787-732-1390
Practice Address - Street 1:31 CALLE RAFAEL LASA
Practice Address - Street 2:
Practice Address - City:AGUAS BUENAS
Practice Address - State:PR
Practice Address - Zip Code:00703-3218
Practice Address - Country:US
Practice Address - Phone:787-732-3131
Practice Address - Fax:787-732-1390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-20
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
PR17F22723336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2082826OtherPK