Healthcare Provider Details

I. General information

NPI: 1629133137
Provider Name (Legal Business Name): FARMACIA LA RAMPLA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 06/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 CALLE CRISTOBAL COLON
YABUCOA PR
00767-3340
US

IV. Provider business mailing address

52 CALLE CRISTOBAL COLON PO BOX 1911
YABUCOA PR
00767-3340
US

V. Phone/Fax

Practice location:
  • Phone: 787-893-3590
  • Fax: 787-893-3984
Mailing address:
  • Phone: 787-893-3590
  • Fax: 787-893-3984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: MR. EDWIN GOMEZ
Title or Position: OWNER
Credential: PRESIDENT
Phone: 787-893-3590