Healthcare Provider Details

I. General information

NPI: 1932657558
Provider Name (Legal Business Name): FARMACIA SONIA J D INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2016
Last Update Date: 03/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 149 KM 66.9 BO. LOMAS
JUANA DIAZ PR
00795
US

IV. Provider business mailing address

61 CALLE COMERCIO
JUANA DIAZ PR
00795-1658
US

V. Phone/Fax

Practice location:
  • Phone: 787-837-2666
  • Fax: 787-837-4602
Mailing address:
  • Phone: 787-837-2666
  • Fax: 787-837-4602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number18-F-3402
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SONIA TORO
Title or Position: PRESIDENT
Credential:
Phone: 787-837-2666