Provider Demographics
NPI:1992927461
Name:FARMACIA AMIGA, INC.
Entity type:Organization
Organization Name:FARMACIA AMIGA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTA
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CABAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-752-6246
Mailing Address - Street 1:CENTRO COMERCIAL MONSERRATE PLAZA
Mailing Address - Street 2:AVENIDA MONSERRATE VILLA CAROLINA
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00985-5444
Mailing Address - Country:US
Mailing Address - Phone:787-752-6246
Mailing Address - Fax:787-762-4070
Practice Address - Street 1:CENTRO COMERCIAL MONSERRATE PLAZA
Practice Address - Street 2:AVENIDA MONSERRATE VILLA CAROLINA
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985-5444
Practice Address - Country:US
Practice Address - Phone:787-752-6246
Practice Address - Fax:787-762-4070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07F0478332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4419060001Medicare ID - Type Unspecified