Organization
MIAA INC
Active
Other names
Farmacia La 100
Organization subpart
No
Provider details
NPI number
Authorized official
IVELISSE CINTRON (OWNER/RPH/I/C)
(939) 910-7910
Entity
Organization
Contact information
Practice address
CARR 100 KM 5.8, BO. MIRADERO, CABO ROJO, PR 00623
(939) 910-7910
(939) 910-7911
Mailing address
CALLE BRAU # 44, CABO ROJO, PR 00623
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
14F3077
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4028379
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/11/2013
Last updated
01/31/2013
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