# JORGE SANTIAGO SANTIAGO

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

## Provider details

- **NPI number:** 1801978689
- **Authorized official:** JORGE SANTIAGO (OWNER)
- **Authorized official phone:** (787) 863-4445

## Contact information

- **Practice address:** URB. MONTE BRISAS I, A 21CALLE J, FAJARDO, PR 00738-3349
- **Practice address phone:** (787) 863-4445
- **Practice address fax:** (787) 863-4544
- **Mailing address:** URB. MONTE BRISAS I, A 21CALLE J, FAJARDO, PR 00738-3349
- **Mailing address phone:** (787) 863-4445
- **Mailing address fax:** (787) 863-4544

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 17F1083 | PR | Yes |

## Other

- **Enumeration date:** 10/20/2006
- **Last updated:** 04/18/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2084709 | PK | — |