Provider Demographics
NPI:1194938779
Name:FARMACIA LA VENTANA INC.
Entity type:Organization
Organization Name:FARMACIA LA VENTANA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAVIER
Authorized Official - Middle Name:ALFONSO
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-835-3525
Mailing Address - Street 1:129 CALLE LUIS MUNOZ RIVERA
Mailing Address - Street 2:
Mailing Address - City:GUAYANILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00656-1810
Mailing Address - Country:US
Mailing Address - Phone:787-835-3524
Mailing Address - Fax:787-835-1125
Practice Address - Street 1:129 CALLE LUIS MUNOZ RIVERA
Practice Address - Street 2:
Practice Address - City:GUAYANILLA
Practice Address - State:PR
Practice Address - Zip Code:00656-1810
Practice Address - Country:US
Practice Address - Phone:787-835-3524
Practice Address - Fax:787-835-1125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR09-F-19673336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4019419OtherNCPDP
PR4019419OtherNCPDP