Healthcare Provider Details

I. General information

NPI: 1285964510
Provider Name (Legal Business Name): FARMACIA DEL ATLANTICO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2010
Last Update Date: 02/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 493 KM 0.5 EDIF. MEDICAL AND PROFESIONAL PLAZA #111
HATILLO PR
00659-0862
US

IV. Provider business mailing address

PO BOX 141133
ARECIBO PR
00614-1133
US

V. Phone/Fax

Practice location:
  • Phone: 787-880-7171
  • Fax: 787-880-8787
Mailing address:
  • Phone: 787-880-7171
  • Fax: 787-880-8787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. JESUS M. RODRIGUEZ
Title or Position: OWNER
Credential:
Phone: 787-347-1806