1659586964 NPI number — SALVADOR LOPEZ-ROJAS

Table of content: (NPI 1659586964)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659586964 NPI number — SALVADOR LOPEZ-ROJAS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SALVADOR LOPEZ-ROJAS
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:
SUPER FARMACIA VISALMARY
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:
1659586964
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/19/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 30000
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SABANA HOYOS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00688-3000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-878-8052
Provider Business Mailing Address Fax Number:
787-878-8052

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ROAD #2 RAMAL 638 KM. 6.0
Provider Second Line Business Practice Location Address:
MIRAFLORES
Provider Business Practice Location Address City Name:
ARECIBO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-878-8052
Provider Business Practice Location Address Fax Number:
787-878-8052
Provider Enumeration Date:
05/11/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LOPEZ
Authorized Official First Name:
SALVADOR
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
787-878-8052

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  479770001 , 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)