Organization
MYTILINI ENTERPRISES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES FANARAS (PRESIDENT)
(603) 224-9591
Entity
Organization
Contact information
Practice address
209 ROUTE 101, BEDFORD, NH 03110-5440
(603) 472-3919
(603) 472-7448
Mailing address
209 ROUTE 101, BEDFORD, NH 03110-5440
(603) 472-3919
(603) 472-7448
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
50
NH
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2166929
PK
—
05
—
80872998
—
NH
Enumeration date
09/07/2006
Last updated
04/25/2017
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up