Provider Demographics
NPI:1285964510
Name:FARMACIA DEL ATLANTICO
Entity type:Organization
Organization Name:FARMACIA DEL ATLANTICO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JESUS
Authorized Official - Middle Name:M
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-347-1806
Mailing Address - Street 1:PO BOX 141133
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614-1133
Mailing Address - Country:US
Mailing Address - Phone:787-880-7171
Mailing Address - Fax:787-880-8787
Practice Address - Street 1:CARR 493 KM 0.5
Practice Address - Street 2:EDIF. MEDICAL AND PROFESIONAL PLAZA #111
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659-0862
Practice Address - Country:US
Practice Address - Phone:787-880-7171
Practice Address - Fax:787-880-8787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-08
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy