Provider Demographics
NPI:1417774043
Name:FARMACIA LA TORRE LLC
Entity type:Organization
Organization Name:FARMACIA LA TORRE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COMPANY PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GUILLERMO
Authorized Official - Middle Name:
Authorized Official - Last Name:RIOS TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD, PHARMACIST
Authorized Official - Phone:787-690-1737
Mailing Address - Street 1:MANSIONES EN PASEO DE REYES
Mailing Address - Street 2:F81
Mailing Address - City:JUANA DIAZ
Mailing Address - State:PR
Mailing Address - Zip Code:00795
Mailing Address - Country:US
Mailing Address - Phone:787-931-7217
Mailing Address - Fax:787-931-7219
Practice Address - Street 1:PLAZA SAN LUCAS EDIFICIO TORRE MEDICA SAN LUCAS
Practice Address - Street 2:PRIMER NIVEL LOCAL 12 A, AVE TITO CASTRO CARR # 14
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717
Practice Address - Country:US
Practice Address - Phone:787-931-7217
Practice Address - Fax:787-931-7219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-24
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR039928400Medicaid