1811149388 NPI number — FARMACIA BELMONTE INC

Table of content: (NPI 1811149388)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811149388 NPI number — FARMACIA BELMONTE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FARMACIA BELMONTE INC
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:
FARMACIA BELMONTE #4
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:
1811149388
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/21/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1085
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HORMIGUEROS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00660-1085
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-849-4173
Provider Business Mailing Address Fax Number:
787-264-7171

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR. 3344, KM 0.1, CALLE FAS COMERCIO INT.
Provider Second Line Business Practice Location Address:
HORMIGUEROS PLAZA
Provider Business Practice Location Address City Name:
HORMIGUEROS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00660
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-849-4704
Provider Business Practice Location Address Fax Number:
787-849-3133
Provider Enumeration Date:
10/16/2008

Additional Information

Authorized Official

Authorized Official Last Name:
MARTINEZ
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-849-4173

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  18-F-3215 , 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: 2117461 . This is a "PK" identifier . This identifiers is of the category "OTHER".




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