Healthcare Provider Details

I. General information

NPI: 1710922232
Provider Name (Legal Business Name): FARMACIA BIENESTAR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2006
Last Update Date: 07/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR.#2 KM 42.9 BO ALGARROBO
VEGA BAJA PR
00693
US

IV. Provider business mailing address

PO BOX 141492
ARECIBO PR
00614
US

V. Phone/Fax

Practice location:
  • Phone: 787-855-2300
  • Fax: 787-855-2301
Mailing address:
  • Phone: 787-855-2300
  • Fax: 787-855-2301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number17-F-2762
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ADA JOVE
Title or Position: PHARMACIST-OWNER
Credential:
Phone: 787-855-2300