Provider Demographics
NPI:1871533638
Name:FARMACIA VALLEMAR
Entity type:Organization
Organization Name:FARMACIA VALLEMAR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LILLIAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:VALLE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:787-785-2458
Mailing Address - Street 1:PO BOX 11175
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00922-1175
Mailing Address - Country:US
Mailing Address - Phone:787-785-2458
Mailing Address - Fax:787-785-2458
Practice Address - Street 1:Z1 AVE CARLOS J ANDALUZ
Practice Address - Street 2:URB. LOMAS VERDES
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956-3467
Practice Address - Country:US
Practice Address - Phone:787-785-2458
Practice Address - Fax:787-785-2458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3871850001332B00000X
PR07-F-16553336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4021604OtherNABP
PR4021604OtherNABP