Organization Active NPI

Wilmet I Millan Camacho

  • Community/Retail Pharmacy
  • Humacao, PR
National Provider Identifier
1629395090
Registry record updated Aug 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
12F2837 Issued in PR
Legal business name
WILMET I MILLAN CAMACHO
Doing business as
Farmacia Rosalina
Practice address
344 Calle Font Martelo
Humacao, PR 00791-3228
Phone
(787) 850-2040
Fax
(787) 850-2232
NPI assigned
Apr 26, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2019

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

Authorized official

Name
Wilmet Millan
Title
Owner
Phone
(787) 397-2161

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 12F2837 PR Primary
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

344 Calle Font Martelo
Humacao, PR 00791-3228

Mailing address

PO Bo Box 8364
Humacao, PR 00792-8364
Phone (787) 850-2040

Other identifiers 1

IdentifierTypeStateIssuer
4027339OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • Farmacia Rosalina Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190903002522 PR Part B Supplier - Mass Immunization (Roster Biller Only) 8820327703 Practice locations: Humacao, PR

National Provider Directory

National Provider Directory

Locations

344 Calle Font Martelo
Humacao, PR 00791
Phone (787) 850-2040

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1272240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567036800000",
    "number": "1629395090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BO BOX 8364",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "007928364",
            "telephone_number": "787-850-2040",
            "fax_number": "787-850-2232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "344 CALLE FONT MARTELO",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "007913228",
            "telephone_number": "787-850-2040",
            "fax_number": "787-850-2232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILMET I MILLAN CAMACHO",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-26",
        "last_updated": "2019-08-29",
        "status": "A",
        "authorized_official_last_name": "MILLAN",
        "authorized_official_first_name": "WILMET",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "787-397-2161"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PR",
            "license": "12F2837",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4027339",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Farmacia Rosalina",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Farmacia Rosalina",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Humacao, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2019; 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.