Provider Demographics
NPI:1194283788
Name:FARMACIA VICTORIA INC
Entity type:Organization
Organization Name:FARMACIA VICTORIA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NIMIA
Authorized Official - Middle Name:I
Authorized Official - Last Name:VAZQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:787-485-1097
Mailing Address - Street 1:773 AVE SAN PATRICIO
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921-1301
Mailing Address - Country:US
Mailing Address - Phone:787-485-1097
Mailing Address - Fax:787-998-2802
Practice Address - Street 1:773 AVE SAN PATRICIO
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-1301
Practice Address - Country:US
Practice Address - Phone:787-485-1097
Practice Address - Fax:787-998-2802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-04
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy