1821489519 NPI number — RX SERVICES INC

Table of content: (NPI 1821489519)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821489519 NPI number — RX SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RX SERVICES 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 VIDA
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:
1821489519
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/13/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
EST DEL GOLF CLUB
Provider Second Line Business Mailing Address:
582 CALLE LUIS MORALES
Provider Business Mailing Address City Name:
PONCE
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00730
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-840-2015
Provider Business Mailing Address Fax Number:
787-840-2017

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CENTRO DEL SUR MALL
Provider Second Line Business Practice Location Address:
BLVD MIGUEL A POU KM 26.4
Provider Business Practice Location Address City Name:
PONCE
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00717-2702
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-840-2015
Provider Business Practice Location Address Fax Number:
787-840-2017
Provider Enumeration Date:
02/17/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FELICIANO
Authorized Official First Name:
MELISSA
Authorized Official Middle Name:
Authorized Official Title or Position:
PHARMACY MANAGER/OWNER
Authorized Official Telephone Number:
787-840-2015

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-3264 , 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: 2150209 . This is a "PK" identifier . This identifiers is of the category "OTHER".