1578053773 NPI number — FARMACIA PORTA DEL SOL CORPORATION

Table of content: (NPI 1578053773)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578053773 NPI number — FARMACIA PORTA DEL SOL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FARMACIA PORTA DEL SOL CORPORATION
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:
1578053773
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/26/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
257 LAS QUINTAS
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN GERMAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00683
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-476-7676
Provider Business Mailing Address Fax Number:
787-476-7606

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
BO. RETIRO CARR. 102 KM 34.4
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN GERMAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00683
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-476-7676
Provider Business Practice Location Address Fax Number:
787-476-7606
Provider Enumeration Date:
05/14/2018

Additional Information

Authorized Official

Authorized Official Last Name:
CARMONA
Authorized Official First Name:
MARIA
Authorized Official Middle Name:
DEL PILAR
Authorized Official Title or Position:
PHARMACIST
Authorized Official Telephone Number:
787-476-7676

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: 039201900 , issued by the state of ( PR ) . This identifiers is of the category "MEDICAID".




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