Basic Information
| Provider Information | |||||||||
| NPI: | 1306978317 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | FARMACIA HOSPITAL DAMAS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2213 PONCE BYPASS | ||||||||
| Address2: | |||||||||
| City: | PONCE | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007171318 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 2213 PONCE BYPASS | ||||||||
| Address2: | |||||||||
| City: | PONCE | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007171318 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878408686 | ||||||||
| FaxNumber: | 7878438999 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/12/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | HOMS | ||||||||
| AuthorizedOfficialFirstName: | SILMA | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PHARMACY DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 7878408686 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3336C0003X | 07-F-0929 | PR | Y | Suppliers | Pharmacy | Community/Retail Pharmacy |
No ID Information.