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NPI Code Detail

MEDICARE: FARMACIA MEDINA 5 INC

MEDICARE: FARMACIA MEDINA 5 INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336C0003XCommunity/Retail Pharmacy18-F-3048PR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12136408OTHERPK

General Provider Information

NPI Number : 1639236946
Entity Type Code : Organization
Provider Name (Legal Business Name) : FARMACIA MEDINA 5 INC
Provider Business Mailing Address
First Line : BO SABANA LLANA
Second Line : 486 CALLE DE DIEGO
City : SAN JUAN
State : PR
Zip : 00923-3141
Country : US
Telephone Number : 787-763-0255
Fax Number : 787-763-0360
Provider Business Practice Location Address
First Line : BO SABANA LLANA
Second Line : 486 CALLE DE DIEGO
City : SAN JUAN
State : PR
Zip : 00923-3141
Country : US
Telephone Number : 787-763-0255
Fax Number : 787-763-0360
Authorized Official
Title or Position : PRESIDENT
Name : JOEL CORDERO
Credential : RPH
Telephone Number : 787-763-0255
Provider Enumeration Date : 01/03/2007
Last Update Date : 02/28/2017

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Directions to “FARMACIA MEDINA 5 INC ” Practice Location

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