Provider Demographics
NPI:1366586067
Name:FARMACIA EL YUNQUE INC
Entity type:Organization
Organization Name:FARMACIA EL YUNQUE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHRM
Authorized Official - Prefix:
Authorized Official - First Name:MARIBEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNANDEZ CHARBONIER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:787-888-1700
Mailing Address - Street 1:CALLE PIMENTEL 41 C3
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00745
Mailing Address - Country:US
Mailing Address - Phone:787-888-1700
Mailing Address - Fax:787-887-7226
Practice Address - Street 1:CALLE PIMENTEL 41 C3
Practice Address - Street 2:
Practice Address - City:RIO GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00745
Practice Address - Country:US
Practice Address - Phone:787-888-1700
Practice Address - Fax:787-887-7226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17F31463336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2087553OtherPK