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General NPI Number Information
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NPI Number | 1609910793
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Entity Type | Organization
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Legal Business Name | FARMACIA LA FE 4
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 108 CALLE VICTORIA
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City | PONCE
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State | PR
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Zip | 00730-3767
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Country | US
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Telephone | 787-842-3201
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Fax | 787-848-0858
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Provider Business Mailing Address
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Address Line | CARR 371 KM 17 BO ALMACIGO BAJO
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City | YAUCO
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State | PR
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Zip | 00698
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Country | US
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Telephone | 787-267-2007
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Fax | 787-267-2047
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Authorized Official
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Title or Position | PHARMACIST
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Name | DR. LOURDES D RODRIGUEZ
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Credential |
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Telephone | 787-267-2007
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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 | 07F2044
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License Number State | PR
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