# LDCA ENTERPRISE INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CIV Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508102518
- **Authorized official:** CARLOS VILLAHERMOSA CPC , PMB (PRESIDENT)
- **Authorized official phone:** (787) 374-7467

## Contact information

- **Practice address:** CARR 125 KM 21.9 BO. BAHOMAMEY, SAN SEBASTIAN MEDICAL CENTER SUITE \# 4, SAN SEBASTIAN, PR 00685
- **Practice address phone:** (787) 926-7999
- **Practice address fax:** (787) 926-7899
- **Mailing address:** PO BOX 902, SAN SEBASTIAN, PR 00685-0902

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 16-F-3080 | PR | Yes |

## Other

- **Enumeration date:** 12/19/2012
- **Last updated:** 08/06/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2138233 | PK | — |