1174754881 NPI number — FARMACIA CENTRO SALUD FAMILIAR ARAGO

Table of content: (NPI 1174754881)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174754881 NPI number — FARMACIA CENTRO SALUD FAMILIAR ARAGO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FARMACIA CENTRO SALUD FAMILIAR ARAGO
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:
CENTRO DE SALUD FAMILIAR JULIO PALMIERI FERRI
Provider Other Organization Name Type Code:
4
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:
1174754881
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/19/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P O BOX 450
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARROYO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00714-0450
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-839-4150
Provider Business Mailing Address Fax Number:
787-839-3989

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CALLE MORSE ESQ VALENTINA
Provider Second Line Business Practice Location Address:
#46
Provider Business Practice Location Address City Name:
ARROYO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00714-0450
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-839-4150
Provider Business Practice Location Address Fax Number:
787-839-1001
Provider Enumeration Date:
07/29/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
RAMIREZ
Authorized Official First Name:
GLORIANN
Authorized Official Middle Name:
M
Authorized Official Title or Position:
CEO / EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
787-839-4150

Provider Taxonomy Codes

  • Taxonomy code: 333600000X , with the licence number:  11-F-1437 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0002X , with the licence number: 11-F-1437 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 038107100 , issued by the state of ( PR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4024458 . This is a "NABP" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 4024458 . This is a "NCPDP" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".