Organization
DIVAMAR INC
Active
Other names
FARMACIA BAIROA
Organization subpart
No
Provider details
NPI number
Authorized official
MODESTO SANTIAGO (PRESIDENT)
(787) 744-9164
Entity
Organization
Contact information
Practice address
CALLE LA PINTA BF-15 AVE. BAIROA, BAIROA CAGUAS, PR 00725-1472
(787) 744-9164
(787) 744-3988
Mailing address
CALLE LA PINTA BF-15 AVE. BAIROA, BAIROA CAGUAS, PR 00725-1472
(787) 744-9164
(787) 744-3988
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
18-F-2423
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038372400
—
PR
01
—
2084107
PK
—
Enumeration date
02/22/2007
Last updated
09/30/2025
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