# FARMACIA SAN RAFAEL SANTURCE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** San Rafael Specialty
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417371303
- **Authorized official:** RAFAEL DIAZ REYES (PRESIDENT)
- **Authorized official phone:** (787) 724-3307

## Contact information

- **Practice address:** 851 CALLE LAFAYETTE, SAN JUAN, PR 00909-2627
- **Practice address phone:** (787) 724-3307
- **Practice address fax:** (787) 919-7058
- **Mailing address:** PO BOX 19791, SAN JUAN, PR 00910-1791
- **Mailing address phone:** (787) 724-3307
- **Mailing address fax:** (787) 919-7058

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336S0011X | Specialty Pharmacy | 17-F-2298 | PR | Yes |

## Other

- **Enumeration date:** 02/12/2014
- **Last updated:** 04/19/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2144222 | PK | — |