Provider Demographics
NPI:1134231442
Name:FARMACIA ENCARNACION
Entity type:Organization
Organization Name:FARMACIA ENCARNACION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DORA
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:787-851-1250
Mailing Address - Street 1:45 CALLE MUNOZ RIVERA
Mailing Address - Street 2:
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623-4041
Mailing Address - Country:US
Mailing Address - Phone:787-851-1250
Mailing Address - Fax:787-851-1250
Practice Address - Street 1:45 CALLE MUNOZ RIVERA
Practice Address - Street 2:
Practice Address - City:CABO ROJO
Practice Address - State:PR
Practice Address - Zip Code:00623-4041
Practice Address - Country:US
Practice Address - Phone:787-851-1250
Practice Address - Fax:787-851-1250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07-F-02823336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4485860001Medicare ID - Type UnspecifiedPHARMACY HOSPITAL SUPPLY