Provider Demographics
NPI:1265619126
Name:FARMACIA BUEN SAMARITANO
Entity type:Organization
Organization Name:FARMACIA BUEN SAMARITANO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTORA DE SERVICIOS ANCILARES
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLANUEVA-CABRERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-658-0000
Mailing Address - Street 1:PO BOX 4055
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00605
Mailing Address - Country:US
Mailing Address - Phone:787-658-0000
Mailing Address - Fax:787-819-0870
Practice Address - Street 1:AVENIDA SEVERIANO CUEVAS #18
Practice Address - Street 2:
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:787-658-0000
Practice Address - Fax:787-819-0870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-23
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR09-F-25733336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy