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General NPI Number Information
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NPI Number | 1629132782
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Entity Type | Organization
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Legal Business Name | FARMACIA LA FE # 3
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 12/18/2009
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Provider Practice Location Address
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Address Line | CARR 153 KM 2.2 BO FELICIA II DENTRO PONCE CASH & CARRY
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City | SANTA ISABEL
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State | PR
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Zip | 00757
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Country | US
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Telephone | 787-845-6695
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Fax | 787-845-5428
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Provider Business Mailing Address
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Address Line | CARR 153 KM 2.2 BO FELICIA II DENTRO PONCE CASH & CARRY
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City | SANTA ISABEL
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State | PR
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Zip | 00757
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Country | US
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Telephone | 787-845-6695
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Fax | 787-845-5428
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | MR. KERMIT SCHMIDT
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Credential | PHD
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Telephone | 787-845-6695
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 07F1778
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License Number State | PR
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