# PHARMAEXTRA INC

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

## Provider details

- **NPI number:** 1982615522
- **Authorized official:** ELLIOT PACHECO BEAUCHAMP MBA (CEO)
- **Authorized official phone:** (787) 738-5343

## Contact information

- **Practice address:** MUNOZ RIVERA 56 SOUTH, CAYEY, PR 00736
- **Practice address phone:** (787) 738-5343
- **Practice address fax:** (787) 263-2883
- **Mailing address:** PO BOX 372830, CAYEY, PR 00737-2830
- **Mailing address phone:** (787) 738-5343
- **Mailing address fax:** (787) 263-2883

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 18F2690 | PR | Yes |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | — |
| 3336S0011X | Specialty Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 08/10/2006
- **Last updated:** 01/30/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2086486 | PK | — |