Provider Demographics
NPI:1588789747
Name:FARMACIA LEDIS
Entity type:Organization
Organization Name:FARMACIA LEDIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPIETARIA
Authorized Official - Prefix:MISS
Authorized Official - First Name:LYDIA
Authorized Official - Middle Name:GONZALEZ
Authorized Official - Last Name:CINTRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-837-0824
Mailing Address - Street 1:PMB 09
Mailing Address - Street 2:BOX 3504
Mailing Address - City:JUANA DIAZ
Mailing Address - State:PR
Mailing Address - Zip Code:00795
Mailing Address - Country:US
Mailing Address - Phone:787-837-0824
Mailing Address - Fax:
Practice Address - Street 1:BO. SABANALLANA
Practice Address - Street 2:CARR. 510 KM 2.1
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795
Practice Address - Country:US
Practice Address - Phone:787-837-0824
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07F-20353336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy