Provider Demographics
NPI:1336228311
Name:RECETAS PRO MENOS INC
Entity Type:Organization
Organization Name:RECETAS PRO MENOS INC
Other - Org Name:FARMACIA RECETAS POR MENOS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LYDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-722-8914
Mailing Address - Street 1:1660 CALLE SANTA ANA
Mailing Address - Street 2:ESQUINA FIDALGO DIAZ
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00909-2309
Mailing Address - Country:US
Mailing Address - Phone:787-722-8914
Mailing Address - Fax:787-752-3660
Practice Address - Street 1:#5 BB-9 PARQUE HERMOSO
Practice Address - Street 2:VILLA FONTANA PARK
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983
Practice Address - Country:US
Practice Address - Phone:787-752-3335
Practice Address - Fax:787-752-3360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19F21683336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2082888OtherPK