Provider Demographics
NPI:1801930821
Name:FARMACIAS LAS VEGAS
Entity type:Organization
Organization Name:FARMACIAS LAS VEGAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MELENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-788-8414
Mailing Address - Street 1:153 CALLE GANGES
Mailing Address - Street 2:URB. EL PARAISO
Mailing Address - City:RIO PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00926-2917
Mailing Address - Country:US
Mailing Address - Phone:787-763-3556
Mailing Address - Fax:
Practice Address - Street 1:BB1 AVE FLOR DEL VALLE
Practice Address - Street 2:URB. LAS VEGAS
Practice Address - City:CATANO
Practice Address - State:PR
Practice Address - Zip Code:00962-6436
Practice Address - Country:US
Practice Address - Phone:787-788-8414
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2111333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy