Super Farmacia Lizette, Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

4130500001 Issued in PR

Legal business name

SUPER FARMACIA LIZETTE, INC

Practice address

103Gmo Esteves St
Jayuya, PR 00664

Phone

(787) 828-0755

Fax

(787) 828-6908

NPI assigned

Jul 8, 2006

Organization subpart

No

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

Authorized official

Name

Lizette RiveraNPI 1740214311

Title

Owner

Phone

(787) 828-0755

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Practitioners 1

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

• Lizette Rivera

  • Pharmacist
  • Jayuya, PR
  • NPI 1740214311
  NPD Authorized official

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1679506125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1528",
            "city": "JAYUYA",
            "state": "PR",
            "postal_code": "006642528",
            "telephone_number": "787-828-0755",
            "fax_number": "787-828-6908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103GMO ESTEVES ST",
            "city": "JAYUYA",
            "state": "PR",
            "postal_code": "00664",
            "telephone_number": "787-828-0755",
            "fax_number": "787-828-6908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPER FARMACIA LIZETTE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "RIVERA",
        "authorized_official_first_name": "LIZETTE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "787-828-0755"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "PR",
            "license": "4130500001",
            "primary": true
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "PR",
            "license": "07-F-1565",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH DEPARMENT",
            "identifier": "07-F-1565",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMSSCA",
            "identifier": "DF-02185-7",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Giovanny Santiago, MD
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• Amarys Joet Torres Morales, MD
• Miguel Antonio Torres Perez, PH. D
• Ismael Torres Rosario, M.D.
• Alex A. Torres-Garcia, M.D.

• Durable Medical Equipment & Medical Supplies in Jayuya, PR
• Providers in Jayuya, PR by specialty
• Durable Medical Equipment & Medical Supplies in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.