=====================================================
General NPI Number Information
=====================================================
NPI Number | 1104995968
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FARMACIA CAMUY HEALTH SERVICES, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/07/2006
-----------------------------------------------------
Last Update Date | 04/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 63 AVE MUNOZ RIVERA E
-----------------------------------------------------
City | CAMUY
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00627-2630
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-898-2290
-----------------------------------------------------
Fax | 787-262-1210
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 660
-----------------------------------------------------
City | CAMUY
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00627-0660
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-898-2290
-----------------------------------------------------
Fax | 787-262-1210
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | MR. EDDIE PEREZ CABAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 787-898-2290
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------