Healthcare Provider Details

I. General information

NPI: 1366339244
Provider Name (Legal Business Name): MM PHARMACY, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2025
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 AVE. PONCE DE LEON LOCAL A, BO. HATO REY NORTE
SAN JUAN PR
00918
US

IV. Provider business mailing address

PO BOX 55098
BAYAMON PR
00960-4098
US

V. Phone/Fax

Practice location:
  • Phone: 787-988-2027
  • Fax:
Mailing address:
  • Phone: 787-988-2027
  • Fax: 787-988-2027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: LYVETTE MERCADO VELEZ
Title or Position: CHIEF HEALTH OFFICER
Credential:
Phone: 787-988-2027