Provider Demographics
NPI:1477692424
Name:SAN FRANCISCO DRUG CENTER
Entity type:Organization
Organization Name:SAN FRANCISCO DRUG CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHCST
Authorized Official - Prefix:
Authorized Official - First Name:LOURDES
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-354-1176
Mailing Address - Street 1:201 AVE DE DIEGO STE 55
Mailing Address - Street 2:PLAZA SAN FRANCISCO
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-5828
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:201 AVE DE DIEGO STE 55
Practice Address - Street 2:PLAZA SAN FRANCISCO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927-5828
Practice Address - Country:US
Practice Address - Phone:787-751-2893
Practice Address - Fax:787-753-2774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
PR07F09983336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4010815OtherOTHER ID NUMBER
4010815OtherOTHER ID NUMBER-COMMERCIAL NUMBER