Provider Demographics
NPI:1912027723
Name:FARMACIA MEDINA LEVITTOWN
Entity Type:Organization
Organization Name:FARMACIA MEDINA LEVITTOWN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:EMILIA
Authorized Official - Middle Name:MEDINA
Authorized Official - Last Name:MAYSONET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-784-1142
Mailing Address - Street 1:S1 CALLE LEALTAD
Mailing Address - Street 2:URB. LEVITTOWN LAKES
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949-4625
Mailing Address - Country:US
Mailing Address - Phone:787-784-1142
Mailing Address - Fax:787-784-1155
Practice Address - Street 1:S1 CALLE LEALTAD
Practice Address - Street 2:URB. LEVITTOWN LAKES
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949-4625
Practice Address - Country:US
Practice Address - Phone:787-784-1142
Practice Address - Fax:787-784-1155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy