Provider Demographics
NPI:1730390097
Name:FARMACIA IRIZARRY
Entity type:Organization
Organization Name:FARMACIA IRIZARRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:IRIZARRY
Authorized Official - Suffix:
Authorized Official - Credentials:BSPH
Authorized Official - Phone:787-851-1270
Mailing Address - Street 1:38 BARBOSA ST
Mailing Address - Street 2:
Mailing Address - City:CABO ROJO
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00623
Mailing Address - Country:UM
Mailing Address - Phone:787-851-1270
Mailing Address - Fax:787-255-2050
Practice Address - Street 1:38 CALLE BARBOSA
Practice Address - Street 2:
Practice Address - City:CABO ROJO
Practice Address - State:PR
Practice Address - Zip Code:00623-4005
Practice Address - Country:US
Practice Address - Phone:787-851-1270
Practice Address - Fax:787-255-2050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR09-F-09563336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy