Su Farmacia Modelo Z P Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

18-F-3079 Issued in PR

Legal business name

SU FARMACIA MODELO Z P INC

Doing business as

Farmacia Modelo

Practice address

Calle MJ Cabrero
Suite 54
San Sebastian, PR 00685

Phone

(787) 896-1154

Fax

(787) 896-1154

NPI assigned

Dec 19, 2006

Last updated

Apr 25, 2017By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Nilsa Perez Torres

Title

Administrator

Phone

(787) 896-1154

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Farmacia Modelo Doing business as

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Tax ID family

Su Farmacia Modelo ZP Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Su Farmacia Modelo Z.P. Inc.

  dba Farmacia Modelo

  • Community/Retail Pharmacy
  • San Sebastian, PR
  • NPI 1174651475
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493078400000",
    "number": "1578627303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1677",
            "city": "SAN SEBASTIAN",
            "state": "PR",
            "postal_code": "006851677",
            "telephone_number": "787-896-1154",
            "fax_number": "787-896-1154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE MJ CABRERO",
            "address_2": "SUITE 54",
            "city": "SAN SEBASTIAN",
            "state": "PR",
            "postal_code": "00685",
            "telephone_number": "787-896-1154",
            "fax_number": "787-896-1154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SU FARMACIA MODELO Z P INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2017-04-25",
        "status": "A",
        "authorized_official_last_name": "PEREZ TORRES",
        "authorized_official_first_name": "NILSA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "787-896-1154"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "PR",
            "license": "18-F-3079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2139535",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Farmacia Modelo",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Su Farmacia Modelo Z.P. Inc. (Farmacia Modelo)
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• Superior Emergency Services Corp
• Tattuannie Borinquen Office PS
• The Diabetic & Mobility Store, Inc.

• Pharmacy in San Sebastian, PR
• Providers in San Sebastian, PR by specialty
• Pharmacy in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.