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General NPI Number Information
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NPI Number | 1699888339
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Entity Type | Organization
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Legal Business Name | FARMACIA MIR MAR
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Dates
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Enumeration Date | 08/16/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 44 CALLE CALIMANO N BOX 2248
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City | GUAYAMA
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State | PR
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Zip | 00784-2248
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Country | US
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Telephone | 787-864-1962
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Fax | 787-866-2278
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Provider Business Mailing Address
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Address Line | CECICILIA DOMIN GUEZ STREET # 1 EAST P O BOX 2248
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City | GUAYAMA
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State | PR
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Zip | 00784-2248
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Country | US
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Telephone | 787-864-1964
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Fax | 787-866-2278
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Authorized Official
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Title or Position | OWNER
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Name | MR. ARIEL MIRANDA
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Credential |
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Telephone | 787-864-1964
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 07F1050
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License Number State | PR
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