Provider Demographics
NPI:1861539405
Name:FAMMA GROUP CORPORATION
Entity type:Organization
Organization Name:FAMMA GROUP CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARMANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNOZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-812-3789
Mailing Address - Street 1:PO BOX 801091
Mailing Address - Street 2:
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-1091
Mailing Address - Country:US
Mailing Address - Phone:787-812-3789
Mailing Address - Fax:787-812-3787
Practice Address - Street 1:2003 CARR 506 STE 101
Practice Address - Street 2:PLAZA SAN CRISTOBAL 2003
Practice Address - City:COTO LAUREL
Practice Address - State:PR
Practice Address - Zip Code:00780-2927
Practice Address - Country:US
Practice Address - Phone:787-812-3789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07F2285183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4024852OtherNCPDP