1972794048 NPI number — FARMACIA ECONO HUMACAO, INC.

Table of content: (NPI 1972794048)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972794048 NPI number — FARMACIA ECONO HUMACAO, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FARMACIA ECONO HUMACAO, 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:
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:
1972794048
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/10/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
47 CALLE GEORGETTI
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COMERIO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00782-2542
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-852-3711
Provider Business Mailing Address Fax Number:
787-852-5319

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR #3 KM. 82.5 BO. CATANO 11
Provider Second Line Business Practice Location Address:
HUMACAO SHOPPING PLAZA, SUPERMERCADO ECONO
Provider Business Practice Location Address City Name:
HUMACAO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00791
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-852-3711
Provider Business Practice Location Address Fax Number:
787-852-5319
Provider Enumeration Date:
08/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
AGOSTO MARTINEZ
Authorized Official First Name:
JUAN
Authorized Official Middle Name:
C
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
787-852-8480

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)





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