Provider Demographics
NPI:1184705352
Name:MI FARMACIA INC
Entity type:Organization
Organization Name:MI FARMACIA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:B
Authorized Official - Last Name:VELOZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-866-2088
Mailing Address - Street 1:PO BOX 2247
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00785-2247
Mailing Address - Country:US
Mailing Address - Phone:787-866-2088
Mailing Address - Fax:787-866-6051
Practice Address - Street 1:CARRETERA 179 KM 0.3 SECTOR LINEA CAPO
Practice Address - Street 2:
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784
Practice Address - Country:US
Practice Address - Phone:787-866-2088
Practice Address - Fax:787-866-6051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07-F-19193336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4217290001Medicare NSC