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Organization
FAME LLC
Active
Organization
FAME LLC
Active
Other names
Farmacia San Martin
Organization subpart
No
Provider details
NPI number
Authorized official
FELIX A MALDONADO PHARM. D. (PHARMACIST)
(787) 608-0140
Entity
Organization
Contact information
Practice address
105 CARR 686, KM 17.9, VEGA BAJA, PR 00693-4551
(787) 858-1231
(787) 858-0983
Mailing address
CARRETERA 686, #105, EDIFICIO SAN MARTN, VEGA BAJA, PR 00693
(787) 858-1231
(787) 858-0983
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
07-F-0548
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
039711500
—
PR
01
—
DF-04022-0
SUSTANCIAS CONTROLADAS
PR
01
—
F-1097666
PHARMACY LICENSE
PR
Enumeration date
10/25/2006
Last updated
10/30/2024
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