Provider Demographics
NPI:1639240419
Name:FARMACIA WILMET INC
Entity type:Organization
Organization Name:FARMACIA WILMET INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST MANAGER OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:WILMET
Authorized Official - Middle Name:I
Authorized Official - Last Name:MILLAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST 4411
Authorized Official - Phone:787-893-1210
Mailing Address - Street 1:CRISTOBAL COLON #25
Mailing Address - Street 2:
Mailing Address - City:YABUCOA
Mailing Address - State:PR
Mailing Address - Zip Code:00767
Mailing Address - Country:US
Mailing Address - Phone:787-893-1210
Mailing Address - Fax:787-893-1210
Practice Address - Street 1:CRISTOBAL COLON #25
Practice Address - Street 2:
Practice Address - City:YABACOA
Practice Address - State:PR
Practice Address - Zip Code:00767
Practice Address - Country:US
Practice Address - Phone:787-893-1210
Practice Address - Fax:787-893-1210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07-F-16343336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4020020OtherNABP
1267260001Medicare ID - Type Unspecified