Organization
HAVANA PHARMACY AND MEDICAL SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARTHA MEJIA (FACILITY DIRECTOR)
(303) 750-3600
Entity
Organization
Contact information
Practice address
1555 S HAVANA ST STE HJ, AURORA, CO 80012-5004
(303) 750-3600
(303) 750-3607
Mailing address
1555 S HAVANA ST STE HJ, AURORA, CO 80012-5004
(303) 750-3600
(303) 750-3607
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0000000836
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43558828
—
CO
Enumeration date
03/18/2014
Last updated
03/18/2014
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