Provider Demographics
NPI:1114011871
Name:FARMACIA DEL POZO INC.
Entity type:Organization
Organization Name:FARMACIA DEL POZO INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:RAYMOND
Authorized Official - Last Name:SOTO
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:787-854-2041
Mailing Address - Street 1:PO BOX 1068
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-1068
Mailing Address - Country:US
Mailing Address - Phone:787-854-2041
Mailing Address - Fax:787-884-9039
Practice Address - Street 1:CARR 149 KM, 2.8- INT 668
Practice Address - Street 2:BDA. CORDOVA DAVILA
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-854-2041
Practice Address - Fax:787-884-9039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13F29413336C0003X
PR332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR6667460001Medicare NSC