Provider Demographics
NPI:1205057080
Name:FARMACIA AMERICANA
Entity type:Organization
Organization Name:FARMACIA AMERICANA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:M
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-728-6095
Mailing Address - Street 1:PO BOX 6116
Mailing Address - Street 2:
Mailing Address - City:SANTURCE
Mailing Address - State:PR
Mailing Address - Zip Code:00914-6116
Mailing Address - Country:US
Mailing Address - Phone:787-728-6095
Mailing Address - Fax:787-982-6171
Practice Address - Street 1:1854 CALLE LOIZA
Practice Address - Street 2:
Practice Address - City:SANTURCE
Practice Address - State:PR
Practice Address - Zip Code:00911-1824
Practice Address - Country:US
Practice Address - Phone:787-728-6095
Practice Address - Fax:787-982-6171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3895980001332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR3895980001Medicare ID - Type Unspecified