Provider Demographics
NPI:1720266018
Name:FARMACIA DE TU COMUNIDAD
Entity Type:Organization
Organization Name:FARMACIA DE TU COMUNIDAD
Other - Org Name:FARMACIA DE TU COMUNIDAD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-399-9269
Mailing Address - Street 1:PO BOX 2601
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-2601
Mailing Address - Country:US
Mailing Address - Phone:787-870-6644
Mailing Address - Fax:787-870-3378
Practice Address - Street 1:5 CARR 165
Practice Address - Street 2:BO. QUEBRADA CRUZ,
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00953-2331
Practice Address - Country:US
Practice Address - Phone:787-870-6644
Practice Address - Fax:787-870-3378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-08
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR09F25463336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4026034OtherNCPDP PROVIDER IDENTIFICATION NUMBER