# HIGHWAY PHARMACY MALL INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Highway Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942358858
- **Authorized official:** DR. JOMARIE ORTIZ RIVERA PHARM.D. (PRESIDENT/CHIEF PHARMACIST)
- **Authorized official phone:** (787) 478-0215

## Contact information

- **Practice address:** PLAZA OASIS CARR 153 KM 6.2, SANTA ISABEL, PR 00757
- **Practice address phone:** (787) 845-6272
- **Practice address fax:** (787) 845-6272
- **Mailing address:** PO BOX 1902, COAMO, PR 00769-1902
- **Mailing address phone:** (787) 845-6272
- **Mailing address fax:** (787) 845-6272

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 07F2001 | PR | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 01/08/2007
- **Last updated:** 07/16/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 039814600 | — | PR |