NPIMap

Organization Active NPI

Farmacia Sagrado, Inc.

  • Community/Retail Pharmacy
  • Sabana Grande, PR
National Provider Identifier
1952653776
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
FARMACIA SAGRADO, INC.
Practice address
Calle Angel G. Martinez 3
Sabana Grande, PR 00637
Phone
(939) 910-7920
Fax
(939) 910-7921
NPI assigned
Oct 3, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Authorized official

Name
Ilianette Miranda, RPH.
Title
President
Phone
(787) 448-5914

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

Calle Angel G. Martinez 3
Sabana Grande, PR 00637

Mailing address

PO Box 539
Sabana Grande, PR 00637-0539
Phone (939) 910-7920

Other identifiers 1

IdentifierTypeStateIssuer
038210600MedicaidPR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20131121000194 PR DME Supplier - PharmacyDME Supplier - Medical Supply Company With Registered Pharmacist 3971739921 Practice locations: Sabana Grande, PR
O20210120003252 PR Part B Supplier - Pharmacy 3971739921 Practice locations: Sabana Grande, PR

National Provider Directory

National Provider Directory

Locations

3 Calle Angel G Martinez
Sabana Grande, PR 00637
Phone (939) 910-7920

Practitioners & affiliated clinicians

Practitioners 9

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": "1349222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750723200000",
    "number": "1952653776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 539",
            "city": "SABANA GRANDE",
            "state": "PR",
            "postal_code": "006370539",
            "telephone_number": "939-910-7920",
            "fax_number": "939-910-7921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE ANGEL G. MARTINEZ 3",
            "city": "SABANA GRANDE",
            "state": "PR",
            "postal_code": "00637",
            "telephone_number": "939-910-7920",
            "fax_number": "939-910-7921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARMACIA SAGRADO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-03",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A",
        "authorized_official_last_name": "MIRANDA",
        "authorized_official_first_name": "ILIANETTE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-448-5914",
        "authorized_official_credential": "RPH."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038210600",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sabana Grande, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; 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.