Healthcare Provider Details
I. General information
NPI: 1336183649
Provider Name (Legal Business Name): FARMACIA PAJUIL LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/16/2006
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
CARR 490 KM 3.2 SECTOR PAJUIL BO. CAMPO ALEGRE
HATILLO PR
00659
US
IV. Provider business mailing address
PO BOX 1323
HATILLO PR
00659-1323
US
V. Phone/Fax
- Phone: 787-820-1972
- Fax: 787-680-0188
- Phone: 787-820-1972
- Fax: 787-680-0188
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 19F1215 |
| License Number State | PR |
VIII. Authorized Official
Name: MRS.
ILIA
MALDONADO
Title or Position: PRESIDENT
Credential:
Phone: 561-900-5929