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General NPI Number Information
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NPI Number | 1063555357
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Entity Type | Organization
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Legal Business Name | FARMACIA LA FE REFORMADA INC
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 09/21/2015
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Provider Practice Location Address
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Address Line | CALLE VICTORIA STE 108
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City | PONCE
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State | PR
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Zip | 00730-3767
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Country | US
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Telephone | 787-844-3155
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Fax | 787-848-0858
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Provider Business Mailing Address
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Address Line | CALLE VICTORIA STE 108
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City | PONCE
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State | PR
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Zip | 00730-3767
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Country | US
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Telephone | 787-842-3201
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Fax | 787-848-0858
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Authorized Official
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Title or Position | PHARMACIST
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Name | RAUL QUESADA
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Credential |
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Telephone | 787-844-3155
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 17F0363
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License Number State | PR
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