Provider Demographics
NPI:1356483721
Name:LA MONSERRATE 2220 LLC
Entity type:Organization
Organization Name:LA MONSERRATE 2220 LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:INES
Authorized Official - Middle Name:VICTORIA
Authorized Official - Last Name:ROSARIO RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-824-2220
Mailing Address - Street 1:CALLE MUNOZ RIVERA # 19
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:PR
Mailing Address - Zip Code:00751
Mailing Address - Country:US
Mailing Address - Phone:787-824-2220
Mailing Address - Fax:787-824-5617
Practice Address - Street 1:CALLE MUNOZ RIVERA # 19
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:PR
Practice Address - Zip Code:00751
Practice Address - Country:US
Practice Address - Phone:787-824-2220
Practice Address - Fax:787-824-5617
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FARMACIA PABON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-13
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07F1631333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy