# FARMACIA SANTIAGO INC

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

## Provider details

- **NPI number:** 1619019338
- **Authorized official:** MR. MANUEL SANTIAGO (EXC DIR)
- **Authorized official phone:** (787) 884-1113

## Contact information

- **Practice address:** CARR 670 KM 1.8 BO COTTO NORTE INTERIOR, MANATI, PR 00674
- **Practice address phone:** (787) 884-1114
- **Practice address fax:** (787) 884-0125
- **Mailing address:** PO BOX 3446, MANATI, PR 00674-3446
- **Mailing address phone:** (787) 884-1114
- **Mailing address fax:** (787) 884-0125

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 12F2693 | PR | Yes |

## Other

- **Enumeration date:** 02/12/2007
- **Last updated:** 04/07/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4025587 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |