{
"Npi": {
"NPI": "1689728990",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "FARMACIA POPULAR, INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 1390",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CATANO",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00963-1390",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "787-788-1245",
"MailingAddressFaxNumber": "787-788-1245",
"FirstLinePracticeLocationAddress": "7 CALLE WILSON",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CATANO",
"PracticeLocationAddressStateName": "PR",
"PracticeLocationAddressPostalCode": "00962-4810",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-788-1245",
"PracticeLocationAddressFaxNumber": "787-788-1245",
"EnumerationDate": "01/23/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SANTIAGO",
"AuthorizedOfficialFirstName": "GLADYS",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RPH",
"AuthorizedOfficialTelephoneNumber": "787-788-1245",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "07F-1883 PR",
"LicenseNumberStateCode": "PR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}