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General NPI Number Information
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NPI Number | 1114907763
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Entity Type | Organization
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Legal Business Name | FARMACIA LA AMISTAD INC
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Dates
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Enumeration Date | 01/19/2006
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Last Update Date | 07/06/2023
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Provider Practice Location Address
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Address Line | CARR 863 KM 2.0 BO PAJAROS
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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 | 787-780-2054
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Fax | 787-798-2125
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Provider Business Mailing Address
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Address Line | HC 1 BOX 8017
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City | TOA BAJA
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State | PR
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Zip | 00949-9740
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Country | US
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Telephone | 787-780-2054
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Fax | 787-798-2125
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Authorized Official
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Title or Position | OWNER
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Name | SHERLEEN RIVERA
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Credential |
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Telephone | 787-780-2054
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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 | 17F1756
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License Number State | PR
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