Provider Demographics
NPI:1669512505
Name:EMPRESAS RPR FARMACIA LA CANDELARIA INC.
Entity type:Organization
Organization Name:EMPRESAS RPR FARMACIA LA CANDELARIA INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:DELLY
Authorized Official - Last Name:PEREZ RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-832-3284
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:787-832-3284
Mailing Address - Fax:787-832-3284
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:787-832-3284
Practice Address - Fax:787-832-3284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10F26853336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4018710OtherPHARMACY