# FAME LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Farmacia San Martin
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114001963
- **Authorized official:** FELIX A MALDONADO PHARM. D. (PHARMACIST)
- **Authorized official phone:** (787) 608-0140

## Contact information

- **Practice address:** 105 CARR 686, KM 17.9, VEGA BAJA, PR 00693-4551
- **Practice address phone:** (787) 858-1231
- **Practice address fax:** (787) 858-0983
- **Mailing address:** CARRETERA 686, \#105, EDIFICIO SAN MARTN, VEGA BAJA, PR 00693
- **Mailing address phone:** (787) 858-1231
- **Mailing address fax:** (787) 858-0983

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 07-F-0548 | PR | Yes |

## Other

- **Enumeration date:** 10/25/2006
- **Last updated:** 10/30/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 039711500 | — | PR |
| 01 | — | DF-04022-0 | SUSTANCIAS CONTROLADAS | PR |
| 01 | — | F-1097666 | PHARMACY LICENSE | PR |