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General NPI Number Information
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NPI Number | 1083736946
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Entity Type | Organization
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Legal Business Name | FARMACIA SAN ANTONIO DE PADUA
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | CARR 435 KM 4 2 BARRIO CALABAZA
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City | SAN SEBASTIAN
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State | PR
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Zip | 00685-9000
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Country | US
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Telephone | 787-280-1330
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Fax | 787-280-1330
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Provider Business Mailing Address
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Address Line | PO BOX 1567
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City | SAN SEBASTIAN
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State | PR
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Zip | 00685-9000
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Country | US
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Telephone | 787-280-1330
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Fax | 787-280-1330
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MARITZA COLON
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Credential |
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Telephone | 787-614-9124
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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 | 590M-06
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License Number State | PR
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