# BIENESTAR PHARMACY GROUP

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

## Provider details

- **NPI number:** 1770117509
- **Authorized official:** DR. JOSE R DE TERREFORTE-DIAZ MD, MPH (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (939) 545-0522

## Contact information

- **Practice address:** CARR 718 KM 1.1, BO PASTO, SECT. LA PLAYITA, AIBONITO, PR 00705
- **Practice address phone:** (787) 303-0799
- **Practice address fax:** (787) 333-6188
- **Mailing address:** EDIFICIO CENTRAL, CALLE BALDORIOTY 165 NORTE BUZON \#2, AIBONITO, PR 00705
- **Mailing address phone:** (939) 545-0524
- **Mailing address fax:** (939) 545-0700

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 03/02/2020
- **Last updated:** 04/13/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 039073300 | — | PR |