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General NPI Number Information
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NPI Number | 1003128414
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Entity Type | Organization
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Legal Business Name | FARMACIA CANDELARIA
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Dates
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Enumeration Date | 07/14/2010
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Last Update Date | 05/03/2018
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Provider Practice Location Address
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Address Line | CARR. 865 KM. 4.3 # 88 CANDELARIA ARENA
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City | TOA BAJA
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State | PR
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Zip | 00949
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Country | US
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Telephone | 787-261-9191
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Fax | 787-261-9191
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Provider Business Mailing Address
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Address Line | URB. LAS COLINAS F39 COLINA DEL TOA
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City | TOA BAJA
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State | PR
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Zip | 00949-4940
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Country | US
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Telephone | 787-637-5131
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOSE ORTIZ
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Credential |
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Telephone | 787-637-5131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 20-F-3364
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License Number State | PR
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