# VICTOR A RIVERA INC

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

## Provider details

- **NPI number:** 1770678724
- **Authorized official:** CARLOS RIVERA (PRESIDENT)
- **Authorized official phone:** (787) 869-2460

## Contact information

- **Practice address:** RAMAL CARRETERA 164 KM 0 2, SECTOR DESVIO, NARANJITO, PR 00719
- **Practice address phone:** (787) 869-3345
- **Practice address fax:** (787) 869-5532
- **Mailing address:** PO BOX 923, NARANJITO, PR 00719-0923
- **Mailing address phone:** (787) 869-3345
- **Mailing address fax:** (787) 869-5532

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 17F1622 | PR | Yes |

## Other

- **Enumeration date:** 10/04/2006
- **Last updated:** 12/15/2015