Provider Demographics
NPI:1114249539
Name:PHARMAMED PHARMACY
Entity Type:Organization
Organization Name:PHARMAMED PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:VIRELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-319-3153
Mailing Address - Street 1:PO BOX 627
Mailing Address - Street 2:
Mailing Address - City:BARCELONETA
Mailing Address - State:PR
Mailing Address - Zip Code:00617-0627
Mailing Address - Country:US
Mailing Address - Phone:787-846-7100
Mailing Address - Fax:787-846-7101
Practice Address - Street 1:BARRIO MAGUEYES CARR. # 140 KM 63.4
Practice Address - Street 2:
Practice Address - City:BARCELONETA
Practice Address - State:PR
Practice Address - Zip Code:00617-0627
Practice Address - Country:US
Practice Address - Phone:787-846-7100
Practice Address - Fax:787-846-7101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-26
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11-F-25293336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy