# DRUG SHOPPE INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** FARMACIA SAN JOSE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073661633
- **Authorized official:** RAFAEL OLIVENCIA (OWNER PHCST)
- **Authorized official phone:** (787) 735-2401

## Contact information

- **Practice address:** CALLE SAN JOSE, STE 59, AIBONITO, PR 00705
- **Practice address phone:** (787) 735-2401
- **Practice address fax:** (787) 735-2500
- **Mailing address:** PO BOX 2021, AIBONITO, PR 00705-2021
- **Mailing address phone:** (787) 735-2401
- **Mailing address fax:** (787) 735-2500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 17-F-3257 | PR | Yes |

## Other

- **Enumeration date:** 01/08/2007
- **Last updated:** 01/18/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2084551 | PK | — |