Fame LLC

Organization Active NPI Community/Retail Pharmacy · Vega Baja, PR

NPI 1114001963 · NPPES record last updated Oct 30, 2024

Key facts

NPI
1114001963
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
07-F-0548 (PR)
Legal business name
FAME LLC
Practice address
105 Carr 686
KM 17.9
Vega Baja, PR 00693-4551
Phone
(787) 858-1231
Fax
(787) 858-0983
NPI assigned
Oct 25, 2006
Organization subpart
No

Authorized official

Name
Felix A Maldonado, PHARM. D.
Title
Pharmacist
Phone
(787) 608-0140

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

105 Carr 686
#179
Vega Baja, PR 00693
Phone (787) 858-1231

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 07-F-0548 PR Yes

Addresses

Primary practice location

105 Carr 686
KM 17.9
Vega Baja, PR 00693-4551

Mailing address

Carretera 686
#105, Edificio San Martn
Vega Baja, PR 00693
Phone (787) 858-1231

Other identifiers

IdentifierTypeStateIssuer
039711500MedicaidPR
DF-04022-0OtherPRSUSTANCIAS CONTROLADAS
F-1097666OtherPRPHARMACY LICENSE

Other names

  • Farmacia San Martin Doing business as

Other providers in Vega Baja, PR

All providers in Vega Baja, PR · Community/Retail Pharmacy in Puerto Rico

Sources for this page

Verify at the official NPI Registry.