Healthcare Provider Details

I. General information

NPI: 1255402517
Provider Name (Legal Business Name): FARMACIA BORIQUEN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2006
Last Update Date: 06/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

268 CALLE LUIS MUNOZ RIVERA SUITE 6
GUAYANILLA PR
00656-1713
US

IV. Provider business mailing address

268 CALLE LUIS MUNOZ RIVERA SUITE 6
GUAYANILLA PR
00656-1713
US

V. Phone/Fax

Practice location:
  • Phone: 787-835-5522
  • Fax: 787-835-3020
Mailing address:
  • Phone: 787-835-5522
  • Fax: 787-835-3020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number07F0162
License Number StatePR

VIII. Authorized Official

Name: MRS. RUTH TORRES RIVERA
Title or Position: PHARMACIST OWNER
Credential:
Phone: 787-835-5522