# FARMACIA JIREH INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** FARMACIA JIREH
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063691095
- **Authorized official:** VICTOR MAISONET (PRESIDENT)
- **Authorized official phone:** (787) 882-7900

## Contact information

- **Practice address:** CARR 2 KM 122 CAIMITAL ALTO, AGUADILLA, PR 00603
- **Practice address phone:** (787) 882-7900
- **Practice address fax:** (787) 882-4916
- **Mailing address:** 213 URB VALLES DE ANASCO, ANASCO, PR 00610-9601
- **Mailing address phone:** (787) 882-7900
- **Mailing address fax:** (787) 882-4916

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 18F2680 | PR | Yes |

## Other

- **Enumeration date:** 10/26/2007
- **Last updated:** 03/13/2017