Provider Demographics
NPI:1003979279
Name:FARMACIA JENNY,INC
Entity type:Organization
Organization Name:FARMACIA JENNY,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF PHARMACIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENILSA
Authorized Official - Middle Name:
Authorized Official - Last Name:VELEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:787-829-2480
Mailing Address - Street 1:21 SAN JOAQUIN ST.
Mailing Address - Street 2:CORNER MUNOZ RIVERA
Mailing Address - City:ADJUNTAS
Mailing Address - State:PR
Mailing Address - Zip Code:00601
Mailing Address - Country:US
Mailing Address - Phone:787-829-3000
Mailing Address - Fax:
Practice Address - Street 1:21 CALLE SAN JOAQUIN
Practice Address - Street 2:CORNER MUNOZ RIVERA
Practice Address - City:ADJUNTAS
Practice Address - State:PR
Practice Address - Zip Code:00601-2254
Practice Address - Country:US
Practice Address - Phone:787-829-2480
Practice Address - Fax:787-829-6000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07F2061333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4168610001Medicare NSC