=====================================================
General NPI Number Information
=====================================================
NPI Number | 1174754881
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FARMACIA CENTRO SALUD FAMILIAR ARAGO
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/29/2009
-----------------------------------------------------
Last Update Date | 10/19/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | CALLE MORSE ESQ VALENTINA #46
-----------------------------------------------------
City | ARROYO
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00714-0450
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-839-4150
-----------------------------------------------------
Fax | 787-839-1001
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | P O BOX 450
-----------------------------------------------------
City | ARROYO
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00714-0450
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-839-4150
-----------------------------------------------------
Fax | 787-839-3989
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO / EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | GLORIANN M RAMIREZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 787-839-4150
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number | 11-F-1437
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 3336C0002X
-----------------------------------------------------
Taxonomy Name | Clinic Pharmacy
-----------------------------------------------------
License Number | 11-F-1437
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------