Organization
SUPER FARMACIA LIZETTE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIZETTE RIVERA (OWNER)
(787) 828-0755
Entity
Organization
Contact information
Practice address
103GMO ESTEVES ST, JAYUYA, PR 00664
(787) 828-0755
(787) 828-6908
Mailing address
PO BOX 1528, JAYUYA, PR 00664-2528
(787) 828-0755
(787) 828-6908
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
4130500001
PR
333600000X
Pharmacy
07-F-1565
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07-F-1565
HEALTH DEPARMENT
PR
01
—
DF-02185-7
AMSSCA
PR
Enumeration date
07/08/2006
Last updated
03/07/2023
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