Provider Demographics
NPI:1063556785
Name:FARMACIA SAN BLAS
Entity type:Organization
Organization Name:FARMACIA SAN BLAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:NORMA
Authorized Official - Middle Name:O
Authorized Official - Last Name:ZAYAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-825-1285
Mailing Address - Street 1:9 CALLE BOBBY CAPO
Mailing Address - Street 2:
Mailing Address - City:COAMO
Mailing Address - State:PR
Mailing Address - Zip Code:00769-2422
Mailing Address - Country:US
Mailing Address - Phone:787-825-1285
Mailing Address - Fax:787-825-2228
Practice Address - Street 1:9 CALLE BOBBY CAPO
Practice Address - Street 2:
Practice Address - City:COAMO
Practice Address - State:PR
Practice Address - Zip Code:00769-2422
Practice Address - Country:US
Practice Address - Phone:787-825-1285
Practice Address - Fax:787-825-2228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR09F04053336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy