Provider Demographics
NPI:1265563860
Name:FARMACIA PRAKO
Entity type:Organization
Organization Name:FARMACIA PRAKO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANA
Authorized Official - Middle Name:MERCEDES
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:787-788-2610
Mailing Address - Street 1:78 FLORES STREET
Mailing Address - Street 2:
Mailing Address - City:CATANO
Mailing Address - State:PR
Mailing Address - Zip Code:00962
Mailing Address - Country:US
Mailing Address - Phone:787-788-2610
Mailing Address - Fax:787-788-3636
Practice Address - Street 1:78 FLORES STREET
Practice Address - Street 2:
Practice Address - City:CATANO
Practice Address - State:PR
Practice Address - Zip Code:00962
Practice Address - Country:US
Practice Address - Phone:787-788-2610
Practice Address - Fax:787-788-3636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRDF0112703336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy