Organization Active NPI

Farmacia San Antonio de Aguada Inc

Doing business as Farmacia San Antonio

  • Community/Retail Pharmacy
  • Aguada, PR
National Provider Identifier
1639222086
Registry record updated Feb 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
17F2300 Issued in PR
Legal business name
FARMACIA SAN ANTONIO DE AGUADA INC
Doing business as
Farmacia San Antonio
Practice address
Ave Nativo Alers Desvio Sur
Aguada, PR 00602-0991
Phone
(787) 868-2805
Fax
(787) 252-0311
NPI assigned
Jan 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2017

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

Authorized official

Name
Victor Garcia, RPH
Title
Owner
Phone
(787) 868-2805

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 17F2300 PR Primary

Addresses

Primary practice location

Ave Nativo Alers Desvio Sur
Aguada, PR 00602-0991

Mailing address

PO Box 1061
Aguada, PR 00602-1061
Phone (787) 868-2805

Other identifiers 2

IdentifierTypeStateIssuer
2086301OtherPK
1320440002MedicaidPR

Other names 1

  • Farmacia San Antonio Doing business as

National Provider Directory

National Provider Directory

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": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487289600000",
    "number": "1639222086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1061",
            "city": "AGUADA",
            "state": "PR",
            "postal_code": "006021061",
            "telephone_number": "787-868-2805",
            "fax_number": "787-252-0311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE NATIVO ALERS DESVIO SUR",
            "city": "AGUADA",
            "state": "PR",
            "postal_code": "006020991",
            "telephone_number": "787-868-2805",
            "fax_number": "787-252-0311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARMACIA SAN ANTONIO DE AGUADA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2017-02-17",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "787-868-2805",
        "authorized_official_credential": "RPH"
    },
    "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": "17F2300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2086301",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1320440002",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Farmacia San Antonio",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aguada, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.