1881792562 NPI number — FARMACIA SANTA OLAYA INC

Table of content: (NPI 1881792562)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881792562 NPI number — FARMACIA SANTA OLAYA INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FARMACIA SANTA OLAYA 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 SANTA OLAYA
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:
1881792562
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/16/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
RR 12 BOX 1367
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BAYAMON
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00956-9401
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-797-4966
Provider Business Mailing Address Fax Number:
787-797-5117

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARRETERA 829 KM 6. 7
Provider Second Line Business Practice Location Address:
BO SANTA OLAYA
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00956
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-797-4966
Provider Business Practice Location Address Fax Number:
787-797-5117
Provider Enumeration Date:
09/20/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FIGUEROA
Authorized Official First Name:
JAIME
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
787-797-4966

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: 18F2835 , 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: 2087120 . This is a "PK" identifier . This identifiers is of the category "OTHER".