Healthcare Provider Details

I. General information

NPI: 1205930617
Provider Name (Legal Business Name): FARMACIA EXPRESO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2006
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 149 KM 9 8 BO HATO VIEJO SECTOR CAMPAMENTO
CIALES PR
00638-9661
US

IV. Provider business mailing address

500 CARR 149 STE 01
CIALES PR
00638-9662
US

V. Phone/Fax

Practice location:
  • Phone: 787-871-3105
  • Fax: 787-871-3122
Mailing address:
  • Phone: 787-871-3105
  • Fax: 787-871-3122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ANDRES COLON
Title or Position: OWNER AND PHARMACY TECHNICIAN
Credential:
Phone: 787-871-3105