Healthcare Provider Details

I. General information

NPI: 1891909065
Provider Name (Legal Business Name): FARMACIA SANTA ANA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 05/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 CALLE MUNOZ RIVERA
MAUNABO PR
00707-2146
US

IV. Provider business mailing address

39 CALLE MUNOZ RIVERA
MAUNABO PR
00707-2146
US

V. Phone/Fax

Practice location:
  • Phone: 787-861-1643
  • Fax: 787-861-3420
Mailing address:
  • Phone: 787-861-1643
  • Fax: 787-861-3420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number06-F-0287
License Number StatePR

VIII. Authorized Official

Name: MR. RAMON A CINTRON
Title or Position: PHARMACIST
Credential: LCDO
Phone: 787-861-3420