Provider Demographics
NPI:1588460133
Name:FARMACIA NOVAVIDA LLC
Entity type:Organization
Organization Name:FARMACIA NOVAVIDA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TECNICO DE FARMACIA
Authorized Official - Prefix:MISS
Authorized Official - First Name:MYLEISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRETO QUINONES
Authorized Official - Suffix:
Authorized Official - Credentials:TECNICO DE FARMACIA
Authorized Official - Phone:787-207-1766
Mailing Address - Street 1:610 CALLE FRAGATA
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-2132
Mailing Address - Country:US
Mailing Address - Phone:787-207-1766
Mailing Address - Fax:
Practice Address - Street 1:ED PLAZA DEL MAR 8494
Practice Address - Street 2:AVE JOBOS
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662
Practice Address - Country:US
Practice Address - Phone:787-207-1766
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy