MEDICARE: FARMACIA AMIGA, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	07F0478	PR

General Provider Information

NPI Number	:	1992927461
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FARMACIA AMIGA, INC.

Provider Business Mailing Address
First Line	:	CENTRO COMERCIAL MONSERRATE PLAZA
Second Line	:	AVENIDA MONSERRATE VILLA CAROLINA
City	:	CAROLINA
State	:	PR
Zip	:	00985-5444
Country	:	US
Telephone Number	:	787-752-6246
Fax Number	:	787-762-4070

Provider Business Practice Location Address
First Line	:	CENTRO COMERCIAL MONSERRATE PLAZA
Second Line	:	AVENIDA MONSERRATE VILLA CAROLINA
City	:	CAROLINA
State	:	PR
Zip	:	00985-5444
Country	:	US
Telephone Number	:	787-752-6246
Fax Number	:	787-762-4070

Authorized Official
Title or Position	:	PRESIDENTA
Name	:	ANA M. CABAN
Credential	:
Telephone Number	:	787-752-6246

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	08/22/2020

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