Healthcare Provider Details

I. General information

NPI: 1336295906
Provider Name (Legal Business Name): FARMACIA CARIMAR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7032 AVE AGUSTIN RAMOS CALERO
ISABELA PR
00662-3432
US

IV. Provider business mailing address

7032 AVE AGUSTIN RAMOS CALERO
ISABELA PR
00662-3432
US

V. Phone/Fax

Practice location:
  • Phone: 787-872-2860
  • Fax: 787-872-0838
Mailing address:
  • Phone: 787-872-2860
  • Fax: 787-872-0838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number07-F-1661
License Number StatePR

VII. Legacy identifiers

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

# 1
Identifier4017718
Identifier TypeOTHER
Identifier StatePR
Identifier IssuerNCPDP

VIII. Authorized Official

Name: JAVIER LOPEZ
Title or Position: PHARMACIST OWNER
Credential:
Phone: 787-872-2860