Provider Demographics
NPI:1053531186
Name:FARMACIA CLINICAS EXTERNAS
Entity type:Organization
Organization Name:FARMACIA CLINICAS EXTERNAS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANG
Authorized Official - Prefix:
Authorized Official - First Name:OLGA
Authorized Official - Middle Name:
Authorized Official - Last Name:AYALA DEL VALLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-777-3535
Mailing Address - Street 1:PO BOX 2129
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00922-2129
Mailing Address - Country:US
Mailing Address - Phone:787-777-3535
Mailing Address - Fax:787-777-3545
Practice Address - Street 1:BARRIO MONACILLOS
Practice Address - Street 2:
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00922
Practice Address - Country:US
Practice Address - Phone:787-777-3535
Practice Address - Fax:787-777-3545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-30
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11F03173336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4025854OtherNCPDP PROVIDER IDENTIFICATION NUMBER