=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538200928
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FARMACIA RUIZ BELVIS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/09/2007
-----------------------------------------------------
Last Update Date | 04/12/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | AVENIDA RAFAEL CORDERO 17
-----------------------------------------------------
City | CAGUAS
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00725
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-746-4919
-----------------------------------------------------
Fax | 787-258-7060
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | AVENIDA RAFAEL CORDERO 17
-----------------------------------------------------
City | CAGUAS
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00725
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-746-4919
-----------------------------------------------------
Fax | 787-258-7060
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHARM/PRES
-----------------------------------------------------
Name | CARLOS OCASIO
-----------------------------------------------------
Credential | PHRM
-----------------------------------------------------
Telephone | 787-315-2056
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | 17F0368
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------