1003979279 NPI number — FARMACIA JENNY,INC

Table of content: (NPI 1003979279)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003979279 NPI number — FARMACIA JENNY,INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FARMACIA JENNY,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:
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:
1003979279
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/03/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 664
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ADJUNTAS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00601-0664
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-829-3000
Provider Business Mailing Address Fax Number:
787-829-6000

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
21 CALLE SAN JOAQUIN
Provider Second Line Business Practice Location Address:
CORNER MUNOZ RIVERA
Provider Business Practice Location Address City Name:
ADJUNTAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00601-2254
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-829-2480
Provider Business Practice Location Address Fax Number:
787-829-6000
Provider Enumeration Date:
12/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
VELEZ
Authorized Official First Name:
JENILSA
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF PHARMACIST
Authorized Official Telephone Number:
787-829-2480

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 038317300 , issued by the state of ( PR ) . This identifiers is of the category "MEDICAID".




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