Healthcare Provider Details

I. General information

NPI: 1275760431
Provider Name (Legal Business Name): FARMACIA HAYUYA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2009
Last Update Date: 07/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 CARR 144 BO JAYUYA ABAJO, SECTOR SANTA CLARA
JAYUYA PR
00664-1517
US

IV. Provider business mailing address

PO BOX 396
JAYUYA PR
00664-0396
US

V. Phone/Fax

Practice location:
  • Phone: 787-828-4499
  • Fax: 787-987-9190
Mailing address:
  • Phone: 787-828-4499
  • Fax: 787-987-9190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336M0003X
TaxonomyManaged Care Organization Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number15F2735
License Number StatePR

VIII. Authorized Official

Name: MIGDALIA MARTINEZ
Title or Position: PHARMACIST
Credential:
Phone: 787-828-4499