Provider Demographics
NPI:1255508206
Name:FARMACIA GABRIELA INC.
Entity type:Organization
Organization Name:FARMACIA GABRIELA INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LIZ ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:BANCHS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-391-3056
Mailing Address - Street 1:PO BOX 801214
Mailing Address - Street 2:
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-1214
Mailing Address - Country:US
Mailing Address - Phone:787-260-2700
Mailing Address - Fax:787-837-2100
Practice Address - Street 1:CARRETERA 14 KM 11.1 BO COLLORES SECTOR CAYABO
Practice Address - Street 2:
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795
Practice Address - Country:US
Practice Address - Phone:787-260-2700
Practice Address - Fax:787-837-2100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-09
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
PR17F25543336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2087879OtherPK