Provider Demographics
NPI:1013271154
Name:FARMACIA SANTA RITA
Entity Type:Organization
Organization Name:FARMACIA SANTA RITA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FELICIANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-896-1850
Mailing Address - Street 1:PO BOX 486
Mailing Address - Street 2:
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685-0486
Mailing Address - Country:US
Mailing Address - Phone:787-896-1850
Mailing Address - Fax:787-280-1698
Practice Address - Street 1:CALLE JOSE MENDEZ NUM 3
Practice Address - Street 2:
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685-0000
Practice Address - Country:US
Practice Address - Phone:787-896-1850
Practice Address - Fax:787-280-1698
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRO DE DIAGNOSTICO Y TRATAMIENTO DE SAN SEBASTIAN, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-07-03
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13-F-2507332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR13-F-2507OtherHEALTH CARE LICENSE