Healthcare Provider Details

I. General information

NPI: 1023141926
Provider Name (Legal Business Name): FARMACIA SABANA HOYOS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 05/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ROAD 639 KM 4.8
SABANA HOYOS PR
00688
US

IV. Provider business mailing address

PO BOX 142706
ARECIBO PR
00614-2706
US

V. Phone/Fax

Practice location:
  • Phone: 787-881-4626
  • Fax: 787-881-8052
Mailing address:
  • Phone: 787-881-4626
  • Fax: 787-881-8052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number16F2365
License Number StatePR

VIII. Authorized Official

Name: JOSE FLORES
Title or Position: PRESIDENT
Credential: RPH
Phone: 787-881-4626