Organization
FARMACIA SAN RAFAEL, INC
Active
Other names
SAN RAFAEL MEDICAL EQUIPMENT
Organization subpart
No
Provider details
NPI number
Authorized official
MISS LUZ V DIAZ REYES CFOM, AUX PHARMACY (DEPARTMENT ADMINISTRATION/OWNER)
17877224803
Entity
Organization
Contact information
Practice address
851 CALLE LAFAYETTE, PDA 20, SAN JUAN, PR 00909-2627
(787) 722-4803
(787) 721-3399
Mailing address
851 CALLE LAFAYETTE, PDA 20, SAN JUAN, PR 00909-2627
(787) 722-4803
(787) 721-3399
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
CFOM0538
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15-F-2298
PHARMACY LICENSE
PR
01
—
DF-02802-7
HEALTH DEPARTMENT LICENSE
PR
Enumeration date
06/16/2006
Last updated
05/21/2014
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