NPIMap

Organization Active NPI

Farmacia San Rafael, Inc

  • Durable Medical Equipment & Medical Supplies
  • San Juan, PR
National Provider Identifier
1699710673
Registry record updated May 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
CFOM0538 Issued in VA
Legal business name
FARMACIA SAN RAFAEL, INC
Practice address
851 Calle Lafayette
Pda 20
San Juan, PR 00909-2627
Phone
(787) 722-4803
Fax
(787) 721-3399
NPI assigned
Jun 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2014

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

Authorized official

Name
Miss Luz V Diaz Reyes, CFOM, AUX PHARMACY
Title
Department Administration/Owner
Phone
(787) 722-4803

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X CFOM0538 VA Primary

Addresses

Primary practice location

851 Calle Lafayette
Pda 20
San Juan, PR 00909-2627

Mailing address

851 Calle Lafayette
Pda 20
San Juan, PR 00909-2627
Phone (787) 722-4803

Other identifiers 2

IdentifierTypeStateIssuer
15-F-2298OtherPRPHARMACY LICENSE
DF-02802-7OtherPRHEALTH DEPARTMENT LICENSE

Other names 1

  • SAN RAFAEL MEDICAL EQUIPMENT Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Farmacia San Rafael 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.

Locations

851 Calle Lafayette
San Juan, PR 00909
Phone (787) 724-3307

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400630400000",
    "number": "1699710673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 CALLE LAFAYETTE",
            "address_2": "PDA 20",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009092627",
            "telephone_number": "787-722-4803",
            "fax_number": "787-721-3399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 CALLE LAFAYETTE",
            "address_2": "PDA 20",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009092627",
            "telephone_number": "787-722-4803",
            "fax_number": "787-721-3399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARMACIA SAN RAFAEL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-16",
        "last_updated": "2014-05-21",
        "status": "A",
        "authorized_official_last_name": "DIAZ REYES",
        "authorized_official_first_name": "LUZ",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "DEPARTMENT ADMINISTRATION/OWNER",
        "authorized_official_telephone_number": "17877224803",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "CFOM, AUX PHARMACY"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "VA",
            "license": "CFOM0538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE",
            "identifier": "15-F-2298",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH DEPARTMENT LICENSE",
            "identifier": "DF-02802-7",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SAN RAFAEL MEDICAL EQUIPMENT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2014; 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.