Healthcare Provider Details

I. General information

NPI: 1629104187
Provider Name (Legal Business Name): FARMACIA CHAVES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 CALLE BARBOSA
ISABELA PR
00662-2909
US

IV. Provider business mailing address

27 CALLE BARBOSA
ISABELA PR
00662-2909
US

V. Phone/Fax

Practice location:
  • Phone: 787-872-4545
  • Fax: 787-872-4580
Mailing address:
  • Phone: 787-872-4545
  • Fax: 787-872-4580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number07-F-2083
License Number StatePR

VII. Legacy identifiers

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

VIII. Authorized Official

Name: SONIA I CHAVES
Title or Position: PHARMACIST
Credential:
Phone: 787-872-4545