Provider Demographics
NPI:1740325224
Name:FARMACIA PROFESIONAL ASHFORD
Entity type:Organization
Organization Name:FARMACIA PROFESIONAL ASHFORD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PASTRANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-722-1740
Mailing Address - Street 1:PO BOX 40857
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00940-0857
Mailing Address - Country:US
Mailing Address - Phone:787-722-1740
Mailing Address - Fax:787-721-5349
Practice Address - Street 1:29 CALLE WASHINGTON
Practice Address - Street 2:CONDADO
Practice Address - City:SANTURCE
Practice Address - State:PR
Practice Address - Zip Code:00907-1510
Practice Address - Country:US
Practice Address - Phone:787-722-1740
Practice Address - Fax:787-721-5349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07-F-0230332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1272060001Medicare ID - Type Unspecified