Provider Demographics
NPI:1174754881
Name:FARMACIA CENTRO SALUD FAMILIAR ARAGO
Entity type:Organization
Organization Name:FARMACIA CENTRO SALUD FAMILIAR ARAGO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO / EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GLORIANN
Authorized Official - Middle Name:M
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-839-4150
Mailing Address - Street 1:P O BOX 450
Mailing Address - Street 2:
Mailing Address - City:ARROYO
Mailing Address - State:PR
Mailing Address - Zip Code:00714-0450
Mailing Address - Country:US
Mailing Address - Phone:787-839-4150
Mailing Address - Fax:787-839-3989
Practice Address - Street 1:CALLE MORSE ESQ VALENTINA
Practice Address - Street 2:#46
Practice Address - City:ARROYO
Practice Address - State:PR
Practice Address - Zip Code:00714-0450
Practice Address - Country:US
Practice Address - Phone:787-839-4150
Practice Address - Fax:787-839-1001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-29
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11-F-1437333600000X, 3336C0002X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR038107100Medicaid
PR4024458OtherNABP
PR4024458OtherNCPDP