1144205386 NPI number — FAMILY PHARMACY CONCEPTS

Table of content: (NPI 1144205386)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144205386 NPI number — FAMILY PHARMACY CONCEPTS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FAMILY PHARMACY CONCEPTS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144205386
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/27/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 427
Provider Second Line Business Mailing Address:
PMB 129
Provider Business Mailing Address City Name:
MAYAGUEZ
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00681-0427
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-826-2545
Provider Business Mailing Address Fax Number:
787-826-4022

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
67 CALLE 65 INFANTERIA
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANASCO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00610-2909
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-826-2545
Provider Business Practice Location Address Fax Number:
787-826-4022
Provider Enumeration Date:
12/09/2005

Additional Information

Authorized Official

Authorized Official Last Name:
RIVERA
Authorized Official First Name:
FRANCISCO
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-546-4172

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  09-F-1663 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4021680 . This is a "NABP" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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