Healthcare Provider Details

I. General information

NPI: 1538285200
Provider Name (Legal Business Name): FARMACIA CALDAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. 101 KM. 18.1
BOQUERON PR
00622
US

IV. Provider business mailing address

PO BOX 1146
BOQUERON PR
00622-1146
US

V. Phone/Fax

Practice location:
  • Phone: 787-851-2079
  • Fax: 787-255-3115
Mailing address:
  • Phone: 787-851-2079
  • Fax: 787-255-3115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number09F1799
License Number StatePR

VII. Legacy identifiers

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

VIII. Authorized Official

Name: ARIEL CALDAS
Title or Position: OWNER
Credential:
Phone: 787-851-2079