1043366834 NPI number — FPC EXPRESO, INC

Table of content: (NPI 1043366834)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043366834 NPI number — FPC EXPRESO, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FPC EXPRESO, 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:
6
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:
1043366834
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/12/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 6017
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAROLINA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00984-6017
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-276-2808
Provider Business Mailing Address Fax Number:
787-276-8921

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
AVE PASEO DE LOS GIGANTES ESQ MAIN CALDERON
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:
787-276-2808
Provider Business Practice Location Address Fax Number:
787-276-8921
Provider Enumeration Date:
01/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
COLON
Authorized Official First Name:
LUIS
Authorized Official Middle Name:
G
Authorized Official Title or Position:
OWNER-PHARMACIST
Authorized Official Telephone Number:
787-929-9093

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  07F1544 , 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: 038341200 , issued by the state of ( PR ) . This identifiers is of the category "MEDICAID".




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