# FARMACIA SAN JORGE INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619044864
- **Authorized official:** MRS. LUZ E CRUZ-TORRES MANAGER (MANAGER)
- **Authorized official phone:** (787) 840-5979

## Contact information

- **Practice address:** ST. ATOCHA 87C, PONCE, PR 00731
- **Practice address phone:** (787) 840-5979
- **Practice address fax:** (787) 284-1167
- **Mailing address:** PO BOX 801245, COTO LAUREL, PR 00780-1245
- **Mailing address phone:** (787) 840-5979
- **Mailing address fax:** (787) 284-1167

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 08-F-2342 | PR | Yes |

## Other

- **Enumeration date:** 11/30/2006
- **Last updated:** 06/17/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 08-F-2342 | PHARMACY | PR |