Provider Demographics
NPI:1649260068
Name:DEL MAR PHARMACY SERVICES, INC.
Entity type:Organization
Organization Name:DEL MAR PHARMACY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:DEL MAR
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-260-3441
Mailing Address - Street 1:PO BOX 63
Mailing Address - Street 2:
Mailing Address - City:MERCEDITA
Mailing Address - State:PR
Mailing Address - Zip Code:00715-0063
Mailing Address - Country:US
Mailing Address - Phone:787-260-3441
Mailing Address - Fax:787-260-3441
Practice Address - Street 1:BO. ARUZ, CARR #1 KM 117.9
Practice Address - Street 2:
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795
Practice Address - Country:US
Practice Address - Phone:787-260-3441
Practice Address - Fax:787-260-3441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR03-F-2104333600000X
PR332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered333600000XSuppliersPharmacy
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR55489OtherTRIPLE S
PR4772430001Medicare NSC