Healthcare Provider Details

I. General information

NPI: 1346222866
Provider Name (Legal Business Name): FARMACIA AMERICANA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1854 CALLE LOIZA
SANTURCE PR
00911-1824
US

IV. Provider business mailing address

PO BOX 6116 LOIZA STATION
SANTURCE PR
00914-6116
US

V. Phone/Fax

Practice location:
  • Phone: 787-728-6095
  • Fax: 787-268-5102
Mailing address:
  • Phone: 787-728-6095
  • Fax: 787-268-5102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number07F0291
License Number State

VIII. Authorized Official

Name: MR. PEDRO M FERNANDEZ
Title or Position: PHARMACIST PRESIDENT
Credential: PH
Phone: 787-728-6095