Provider Demographics
NPI:1891827432
Name:SUPER FARMACIA MAYI
Entity Type:Organization
Organization Name:SUPER FARMACIA MAYI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:REY
Authorized Official - Middle Name:J
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHA BS
Authorized Official - Phone:787-892-1485
Mailing Address - Street 1:13 CALLE PRINCIPAL
Mailing Address - Street 2:
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683-4180
Mailing Address - Country:US
Mailing Address - Phone:787-892-1485
Mailing Address - Fax:787-892-5985
Practice Address - Street 1:13 CALLE PRINCIPAL
Practice Address - Street 2:URB. EL RETIRO
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683-4180
Practice Address - Country:US
Practice Address - Phone:787-892-1485
Practice Address - Fax:787-264-1036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2015-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy