Provider Demographics
NPI:1457546871
Name:FARMACIA PAOLA CORP
Entity Type:Organization
Organization Name:FARMACIA PAOLA CORP
Other - Org Name:FARMACIA PAOLA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:NOELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CORTES
Authorized Official - Suffix:
Authorized Official - Credentials:BACHELOR
Authorized Official - Phone:787-374-1383
Mailing Address - Street 1:PO BOX 2340
Mailing Address - Street 2:
Mailing Address - City:COAMO
Mailing Address - State:PR
Mailing Address - Zip Code:00769-4340
Mailing Address - Country:US
Mailing Address - Phone:787-803-4433
Mailing Address - Fax:
Practice Address - Street 1:BO LOS LLANOS CARR 14 KM 26.6
Practice Address - Street 2:
Practice Address - City:COAMO
Practice Address - State:PR
Practice Address - Zip Code:00769
Practice Address - Country:US
Practice Address - Phone:787-803-4433
Practice Address - Fax:787-803-4455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
PR17F31603336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2087570OtherPK