Provider Demographics
NPI:1639963382
Name:FARMACIA LA NUEVA CANDELARIA, LLC.
Entity type:Organization
Organization Name:FARMACIA LA NUEVA CANDELARIA, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:EDGAR
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:787-986-7533
Mailing Address - Street 1:68 CALLE RAMOS ANTONINI E
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680-4929
Mailing Address - Country:US
Mailing Address - Phone:787-986-7533
Mailing Address - Fax:787-827-7319
Practice Address - Street 1:68 CALLE RAMOS ANTONINI E
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-4929
Practice Address - Country:US
Practice Address - Phone:787-986-7533
Practice Address - Fax:787-827-7319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-08
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy