Healthcare Provider Details

I. General information

NPI: 1275674392
Provider Name (Legal Business Name): MEDIC PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2007
Last Update Date: 05/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 ST. SE #1228 REPARTO METROPOLITANO
SAN JUAN PR
00921
US

IV. Provider business mailing address

9 ST. SE #1228 REPARTO METROPOLITANO
SAN JUAN PR
00921
US

V. Phone/Fax

Practice location:
  • Phone: 787-758-8497
  • Fax: 787-759-8192
Mailing address:
  • Phone: 787-758-8497
  • Fax: 787-759-8192

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number18-F-3412
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: GIOVANNI FIGUEROA
Title or Position: OWNER
Credential:
Phone: 787-758-8497