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General NPI Number Information
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NPI Number | 1740491323
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Entity Type | Organization
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Legal Business Name | FARMACIA REMEDIOS, INC.
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 272 E SANTA CLARA ST
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City | SAN JOSE
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State | CA
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Zip | 95113-1908
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Country | US
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Telephone | 408-971-1631
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Fax |
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Provider Business Mailing Address
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Address Line | 272 E SANTA CLARA ST
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City | SAN JOSE
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State | CA
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Zip | 95113-1908
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Country | US
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Telephone | 408-971-1631
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF PHARMACY
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Name | GREGORY TERTES
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Credential | RPH
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Telephone | 510-710-3640
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY47594
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License Number State | CA
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