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General NPI Number Information
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NPI Number | 1902164387
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Entity Type | Organization
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Legal Business Name | FARMACIA SAN MIGUEL SL INC
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Dates
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Enumeration Date | 04/24/2012
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Last Update Date | 04/24/2012
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Provider Practice Location Address
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Address Line | CARRT. 181 KM 0.6 INT. CARRT. 183
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City | SAN LORENZO
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State | PR
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Zip | 00754
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Country | US
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Telephone | 787-736-2900
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Fax | 787-736-2800
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Provider Business Mailing Address
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Address Line | PO BOX 593
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City | GURABO
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State | PR
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Zip | 00778-0593
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Country | US
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Telephone | 939-218-1073
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | JORGE ROSA
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Credential |
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Telephone | 939-218-1073
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 14F3020
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License Number State | PR
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