Provider Demographics
NPI:1861557738
Name:FARMACIA EMANUELLI,INC
Entity type:Organization
Organization Name:FARMACIA EMANUELLI,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:LUGO
Authorized Official - Suffix:
Authorized Official - Credentials:2463
Authorized Official - Phone:787-863-0610
Mailing Address - Street 1:PO BOX 925
Mailing Address - Street 2:
Mailing Address - City:FAJARDO
Mailing Address - State:PR
Mailing Address - Zip Code:00738-0925
Mailing Address - Country:US
Mailing Address - Phone:787-863-0610
Mailing Address - Fax:787-863-5207
Practice Address - Street 1:CALLE MUNIOZ RIVERA
Practice Address - Street 2:#2
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738
Practice Address - Country:US
Practice Address - Phone:787-863-0610
Practice Address - Fax:787-863-5207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRAF42068103336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4003555OtherNABP