1568949741 NPI number — BEST OPTION SPECIALTY PHARMACY, LLC

Table of content: DR. MINDY FARLEY PH.D., LPC, CRC (NPI 1407567977)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568949741 NPI number — BEST OPTION SPECIALTY PHARMACY, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BEST OPTION SPECIALTY PHARMACY, LLC
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:
1568949741
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/20/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
359 DE DIEGO AVE
Provider Second Line Business Mailing Address:
SUITE 601
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00909
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-723-6869
Provider Business Mailing Address Fax Number:
787-723-6987

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
355 DE DIEGO AVE
Provider Second Line Business Practice Location Address:
3RD FLOOR
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00909
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-723-6869
Provider Business Practice Location Address Fax Number:
787-723-6987
Provider Enumeration Date:
07/20/2018

Additional Information

Authorized Official

Authorized Official Last Name:
MARK-TRUYOL
Authorized Official First Name:
JUDITH
Authorized Official Middle Name:
I
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
787-723-6868

Provider Taxonomy Codes

  • Taxonomy code: 3336S0011X , with the licence number:  20-F-3366 , 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)





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