# FARMACIA SAN ANTONIO DE AGUADA INC

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

## Provider details

- **NPI number:** 1639222086
- **Authorized official:** VICTOR GARCIA RPH (OWNER)
- **Authorized official phone:** (787) 868-2805

## Contact information

- **Practice address:** AVE NATIVO ALERS DESVIO SUR, AGUADA, PR 00602-0991
- **Practice address phone:** (787) 868-2805
- **Practice address fax:** (787) 252-0311
- **Mailing address:** PO BOX 1061, AGUADA, PR 00602-1061
- **Mailing address phone:** (787) 868-2805
- **Mailing address fax:** (787) 252-0311

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 17F2300 | PR | Yes |

## Other

- **Enumeration date:** 01/19/2007
- **Last updated:** 02/17/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1320440002 | — | PR |
| 01 | — | 2086301 | PK | — |