Healthcare Provider Details

I. General information

NPI: 1669518494
Provider Name (Legal Business Name): FARMACIA DEL CARMEN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE GEORGETTI #32
BARCELONETA PR
00617-1904
US

IV. Provider business mailing address

CALLE GEORGETTI #32
BARCELONETA PR
00617-1904
US

V. Phone/Fax

Practice location:
  • Phone: 787-846-2170
  • Fax: 787-846-3093
Mailing address:
  • Phone: 787-846-2170
  • Fax: 787-846-3093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number07-F-2052
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier4001094
Identifier TypeOTHER
Identifier StatePR
Identifier IssuerNABP

VIII. Authorized Official

Name: MRS. DIANA ORTIZ ROSADO
Title or Position: PHARMACIST
Credential: RPH
Phone: 787-846-2170