Provider Demographics
NPI:1205911740
Name:FARMACIA SAGRADO CORAZAN
Entity type:Organization
Organization Name:FARMACIA SAGRADO CORAZAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIBEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BELTRAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:787-826-3190
Mailing Address - Street 1:PO BOX 2065
Mailing Address - Street 2:
Mailing Address - City:ANASCO
Mailing Address - State:PR
Mailing Address - Zip Code:00610-3000
Mailing Address - Country:US
Mailing Address - Phone:787-826-3190
Mailing Address - Fax:
Practice Address - Street 1:CARR 402 KM 6.0
Practice Address - Street 2:BO. PINALES
Practice Address - City:ANASCO
Practice Address - State:PR
Practice Address - Zip Code:00610-3000
Practice Address - Country:US
Practice Address - Phone:787-826-3190
Practice Address - Fax:787-826-3190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07-F-2073332B00000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4023975OtherNCPDP
PR4023975OtherNCPDP