Organization
FARMACIAS DEL PUEBLO LLC
Active
Other names
FARMACIAS DEL PUEBLO LLC
Organization subpart
No
Provider details
NPI number
Authorized official
RAMON TANTALEAN RPH (CORPORATE OFFICER)
(973) 523-0500
Entity
Organization
Contact information
Practice address
992-994 MADISON AVE, PATERSON, NJ 07501
(973) 523-0500
(973) 523-1988
Mailing address
992-994 MADISON AVE, PATERSON, NJ 07501
(973) 523-0500
(973) 523-1988
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00596200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2054813
PK
—
05
—
8509204
—
NJ
Enumeration date
09/14/2006
Last updated
12/21/2016
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