Healthcare Provider Details

I. General information

NPI: 1720160476
Provider Name (Legal Business Name): FARMACIA SAN MARTIN BARCELONETA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 CALLE GEORGETTI
BARCELONETA PR
00617-2712
US

IV. Provider business mailing address

9 CALLE GEORGETTI
BARCELONETA PR
00617-2712
US

V. Phone/Fax

Practice location:
  • Phone: 787-846-3474
  • Fax: 787-846-0219
Mailing address:
  • Phone: 787-846-3474
  • Fax: 787-846-0219

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number07-F-0650
License Number StatePR

VII. Legacy identifiers

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

# 1
Identifier07-F-0650
Identifier TypeOTHER
Identifier StatePR
Identifier IssuerSTATE LIC
# 2
IdentifierDF-01412-6
Identifier TypeOTHER
Identifier StatePR
Identifier IssuerSTATE DRUG LIC

VIII. Authorized Official

Name: MR. FELIX ALI MALDONADO
Title or Position: PHARMACIST
Credential: R.PH
Phone: 787-846-3474