Provider Demographics
NPI:1982732194
Name:JOSE A. VAZQUEZ INC
Entity Type:Organization
Organization Name:JOSE A. VAZQUEZ INC
Other - Org Name:FARMACIA MARIE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:A
Authorized Official - Last Name:VAZQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-859-2729
Mailing Address - Street 1:CALLE SAN MANUEL 1
Mailing Address - Street 2:
Mailing Address - City:COROZAL
Mailing Address - State:PR
Mailing Address - Zip Code:00783-2086
Mailing Address - Country:US
Mailing Address - Phone:787-859-2729
Mailing Address - Fax:787-802-4124
Practice Address - Street 1:CALLE SAN MANUEL 1
Practice Address - Street 2:
Practice Address - City:COROZAL
Practice Address - State:PR
Practice Address - Zip Code:00783-2086
Practice Address - Country:US
Practice Address - Phone:787-859-2729
Practice Address - Fax:787-802-4124
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOSE A VAZQUEZ INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-01
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4011514OtherNCPDP