Provider Demographics
NPI:1730156084
Name:MI FARMACIA MEDICAL EQUIPMENT INC.
Entity type:Organization
Organization Name:MI FARMACIA MEDICAL EQUIPMENT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ISMAEL
Authorized Official - Middle Name:OMAR
Authorized Official - Last Name:SANTIAGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-822-0555
Mailing Address - Street 1:PO BOX 312
Mailing Address - Street 2:
Mailing Address - City:FLORIDA
Mailing Address - State:PR
Mailing Address - Zip Code:00650-0312
Mailing Address - Country:US
Mailing Address - Phone:787-822-0555
Mailing Address - Fax:787-822-7036
Practice Address - Street 1:55 CALLE RAMON TORRES
Practice Address - Street 2:
Practice Address - City:FLORIDA
Practice Address - State:PR
Practice Address - Zip Code:00650-2041
Practice Address - Country:US
Practice Address - Phone:787-822-0555
Practice Address - Fax:787-822-7036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-07
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR332B00000X, 332BP3500X
PR07-F-1343333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR50148OtherPREFERRED MEDICARE CHOICE
PR4025OtherAMERICAN HEALTH
PR660372202OtherMCS
PR4025OtherAMERICAN HEALTH
PR50148OtherPREFERRED MEDICARE CHOICE