Provider Demographics
NPI:1982726873
Name:FARMACIA DSALUD... PAVIA
Entity Type:Organization
Organization Name:FARMACIA DSALUD... PAVIA
Other - Org Name:PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INTERNATIONAL DEVELOPER
Authorized Official - Prefix:MR
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:PASTORIZA
Authorized Official - Suffix:I
Authorized Official - Credentials:DO
Authorized Official - Phone:787-878-0330
Mailing Address - Street 1:301 AVE JOSE DE DIEGO
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-4544
Mailing Address - Country:US
Mailing Address - Phone:787-878-0330
Mailing Address - Fax:
Practice Address - Street 1:301 AVE JOSE DE DIEGO
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-4544
Practice Address - Country:US
Practice Address - Phone:787-878-0330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR08F24533336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy