Healthcare Provider Details

I. General information

NPI: 1306978317
Provider Name (Legal Business Name): FARMACIA HOSPITAL DAMAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2213 PONCE BYPASS
PONCE PR
00717-1318
US

IV. Provider business mailing address

2213 PONCE BYPASS
PONCE PR
00717-1318
US

V. Phone/Fax

Practice location:
  • Phone: 787-840-8686
  • Fax: 787-843-8999
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number07-F-0929
License Number StatePR

VIII. Authorized Official

Name: SILMA HOMS
Title or Position: PHARMACY DIRECTOR
Credential:
Phone: 787-840-8686