Provider Demographics
NPI:1689729675
Name:MEJIAS, JOSE (REGISTERED PHARMACIS)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:
Last Name:MEJIAS
Suffix:
Gender:M
Credentials:REGISTERED PHARMACIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2195 VEGA ALTA PR 00692
Mailing Address - Street 2:#58 LUIS MUNOZ RIVERA STREET
Mailing Address - City:VEGA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00692
Mailing Address - Country:US
Mailing Address - Phone:787-883-2460
Mailing Address - Fax:787-883-6151
Practice Address - Street 1:FARMACIA NUEVA LTD INC
Practice Address - Street 2:#58 LUIS MUNOZ RIVERA STREET
Practice Address - City:VEGA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00692
Practice Address - Country:US
Practice Address - Phone:787-883-2460
Practice Address - Fax:787-883-6151
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3532183500000X
FLPS22688183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist