Provider Demographics
NPI:1316079296
Name:FARMACIA HATO ARRIBA
Entity type:Organization
Organization Name:FARMACIA HATO ARRIBA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FARMACEUTICA REGENTE
Authorized Official - Prefix:
Authorized Official - First Name:EDITH
Authorized Official - Middle Name:M
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:787-879-4210
Mailing Address - Street 1:PO BOX 1257
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00613-1257
Mailing Address - Country:US
Mailing Address - Phone:787-879-4210
Mailing Address - Fax:787-879-4211
Practice Address - Street 1:CARR 129 KM 39.3 INT 490 BO HATO ARRIBA
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00613-1257
Practice Address - Country:US
Practice Address - Phone:787-879-4210
Practice Address - Fax:787-879-4211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4020208OtherNABP