# FARMACIA MIR MAR

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699888339
- **Authorized official:** MR. ARIEL MIRANDA (OWNER)
- **Authorized official phone:** (787) 864-1964

## Contact information

- **Practice address:** 44 CALLE CALIMANO N, BOX 2248, GUAYAMA, PR 00784-2248
- **Practice address phone:** (787) 864-1962
- **Practice address fax:** (787) 866-2278
- **Mailing address:** CECICILIA DOMIN GUEZ STREET \# 1 EAST, P O BOX 2248, GUAYAMA, PR 00784-2248
- **Mailing address phone:** (787) 864-1964
- **Mailing address fax:** (787) 866-2278

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 07F1050 | PR | Yes |

## Other

- **Enumeration date:** 08/16/2006
- **Last updated:** 03/07/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 07F1050 | STATE LICENCE | PR |
| 01 | — | DM 015453 | STATE LICENCE ASSMCA | PR |