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General NPI Number Information
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NPI Number | 1396886693
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Entity Type | Organization
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Legal Business Name | FARMACIA SAN JOSE HUMACAO LLC
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | CENTRO COMERCIAL SAN JOSE 11 375 CALLE DR VIDAL ESTE
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City | HUMACAO
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State | PR
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Zip | 00791
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Country | US
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Telephone | 787-852-9494
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Fax | 787-850-7811
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Provider Business Mailing Address
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Address Line | CENTRO COMERCIAL SAN JOSE 375 CALLE DR VIDAL ESTE LOCAL 11
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City | HUMACAO
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State | PR
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Zip | 00791
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Country | US
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Telephone | 787-852-9494
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Fax | 787-850-7811
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Authorized Official
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Title or Position | PHARMACIST
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Name | MR. ARIEL EFREN PEREZ VELAZQUEZ
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Credential | PHARM D
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Telephone | 787-298-9705
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 17F1029
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License Number State | PR
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