Organization
MIDWAY PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LILLIAM DOMINGUEZ RPH (PHARMACIST)
(787) 873-1480
Entity
Organization
Contact information
Practice address
BO MAGINAS 225 C MARGINAL, SABANA GRANDE, PR 00637
(787) 873-1480
(787) 804-1480
Mailing address
BO MAGINA 22S C/MARGINA/STE 2, SABANA GRANDE, PR 00637
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
07F2067
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4023937
OTHER ID NUMBER
—
Enumeration date
08/09/2006
Last updated
02/26/2008
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