Provider Demographics
NPI:1316057417
Name:FARMACIA LUGO, INC.
Entity type:Organization
Organization Name:FARMACIA LUGO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:T
Authorized Official - Last Name:IRIZARRY
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:787-873-0007
Mailing Address - Street 1:HC-10
Mailing Address - Street 2:BOX 7351
Mailing Address - City:SABANA GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00637
Mailing Address - Country:US
Mailing Address - Phone:787-873-0007
Mailing Address - Fax:787-873-0010
Practice Address - Street 1:CARR. 363 KMO HMO
Practice Address - Street 2:130.SANTANA-MAGUINA
Practice Address - City:SABANA GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00637
Practice Address - Country:US
Practice Address - Phone:787-873-0007
Practice Address - Fax:787-873-0010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07F2331333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy