Provider Demographics
NPI:1689253221
Name:FARMACIA MELMAR INC.
Entity Type:Organization
Organization Name:FARMACIA MELMAR INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TECHNICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDINA JIMENEZ
Authorized Official - Suffix:
Authorized Official - Credentials:TECH
Authorized Official - Phone:787-508-0494
Mailing Address - Street 1:31 CALLE LAS VEGAS
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-4240
Mailing Address - Country:US
Mailing Address - Phone:787-508-0494
Mailing Address - Fax:
Practice Address - Street 1:SOLAR 6 BO. GALATEO BAJO
Practice Address - Street 2:CARR. 466
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662
Practice Address - Country:US
Practice Address - Phone:787-830-3335
Practice Address - Fax:787-830-3335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-02
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR039077100Medicaid