1326105560 NPI number — FARMACIA RECETAS Y MAS #4

Table of content: (NPI 1326105560)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326105560 NPI number — FARMACIA RECETAS Y MAS #4

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FARMACIA RECETAS Y MAS #4
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:
RECETAS Y MAS, INC.
Provider Other Organization Name Type Code:
3
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:
1326105560
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/28/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 25247
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00928
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-740-3015
Provider Business Mailing Address Fax Number:
787-740-0970

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
URB VILLA CAROLINA BLQ 11 #19
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CAROLINA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00985
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-769-0324
Provider Business Practice Location Address Fax Number:
787-769-2904
Provider Enumeration Date:
01/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HAMED
Authorized Official First Name:
SABN
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
787-525-9263

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  07-F-0479 , 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: 4011766 . This is a "NCPDP" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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