1326145848 NPI number — SANTIAGO R VARELA

Table of content: (NPI 1326145848)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326145848 NPI number — SANTIAGO R VARELA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SANTIAGO R VARELA
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 BRAU
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:
1326145848
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/02/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 144
Provider Second Line Business Mailing Address:
CALLE SAN ANTONIO #17
Provider Business Mailing Address City Name:
ANASCO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00610-0144
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-826-4400
Provider Business Mailing Address Fax Number:
787-826-6738

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CALLE SAN ANTONIO #17
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANASCO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00610
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-826-4120
Provider Business Practice Location Address Fax Number:
787-826-6738
Provider Enumeration Date:
09/19/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
VARELA
Authorized Official First Name:
SANTIAGO
Authorized Official Middle Name:
R.
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
787-826-4120

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  1314290002 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: 07-F-1287 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336C0004X , with the licence number: 07F1287 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336H0001X , with the licence number: 07F1287 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336S0011X , with the licence number: 07F1287 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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