Provider Demographics
NPI:1104512375
Name:FARMACIA DE COMUNIDAD LLC
Entity type:Organization
Organization Name:FARMACIA DE COMUNIDAD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:ALEXIS
Authorized Official - Last Name:MARRERO NIEVES
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACY TECHNICIAN
Authorized Official - Phone:787-414-0073
Mailing Address - Street 1:URB PALACIOS DE MARBELLA
Mailing Address - Street 2:915 CALLE MAGALLANES
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953
Mailing Address - Country:US
Mailing Address - Phone:787-414-0073
Mailing Address - Fax:
Practice Address - Street 1:CARR 165 KM 5.6
Practice Address - Street 2:BO QUEBRADA CRUZ PARCELA 106
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00953-0095
Practice Address - Country:US
Practice Address - Phone:787-870-6644
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FARMACIA DE COMUNIDAD LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-04-12
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy