1538200894 NPI number — FARMACIA GLADYS INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538200894 NPI number — FARMACIA GLADYS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FARMACIA GLADYS 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 GLADYS INC
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:
1538200894
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/01/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 388
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SABANA SECA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00952-0388
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-795-1562
Provider Business Mailing Address Fax Number:
787-784-0716

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
AVE RAMON RIOS ROMON
Provider Second Line Business Practice Location Address:
STE 112 B
Provider Business Practice Location Address City Name:
SABANA SECA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00952
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-795-1562
Provider Business Practice Location Address Fax Number:
787-784-0716
Provider Enumeration Date:
02/09/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ALICEA COSME
Authorized Official First Name:
GLADYS
Authorized Official Middle Name:
Authorized Official Title or Position:
VP
Authorized Official Telephone Number:
787-795-1562

Provider Taxonomy Codes

  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: 17-F-0265 , 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: 2084701 . This is a "PK" identifier . This identifiers is of the category "OTHER".




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