Healthcare Provider Details

I. General information

NPI: 1023768462
Provider Name (Legal Business Name): FARMACIA LUVAMAR EXPRESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2022
Last Update Date: 03/28/2022
Certification Date: 03/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

#67 CALLE 65 DE INFANTERIA
ANASCO PR
00610
US

IV. Provider business mailing address

PO BOX 518
ANASCO PR
00610-0518
US

V. Phone/Fax

Practice location:
  • Phone: 787-826-2545
  • Fax: 787-826-4022
Mailing address:
  • Phone: 787-826-2545
  • Fax: 787-826-4022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: VANESSA TUR
Title or Position: PHARMACIST
Credential:
Phone: 787-826-2545