Provider Demographics
NPI:1306068846
Name:JULIO SANTOS GARCIA
Entity type:Organization
Organization Name:JULIO SANTOS GARCIA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-798-4028
Mailing Address - Street 1:CARR 174 ESQ CALLE 10 BARRIO JUAN SANCHEZ
Mailing Address - Street 2:153A
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959
Mailing Address - Country:US
Mailing Address - Phone:787-798-4533
Mailing Address - Fax:787-798-4028
Practice Address - Street 1:CARR 174 ESQ CALLE 10 BARRIO JUAN SANCHEZ
Practice Address - Street 2:153A
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-798-4533
Practice Address - Fax:787-798-4028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
PR18F31843336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2084598OtherPK