NPIMap

Organization Active NPI

Farmacia Medina #4 Inc

  • Community/Retail Pharmacy
  • Canoranas, PR
National Provider Identifier
1215026349
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
07F2296 Issued in PR
Legal business name
FARMACIA MEDINA #4 INC
Practice address
Carr 185 KM 02 VRB Zona Industrial
Canoranas, PR 00729
Phone
(787) 256-3592
Fax
(787) 256-0172
NPI assigned
Oct 12, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Irelisse Medina
Title
Manager
Phone
(787) 256-3592

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 07F2296 PR Primary

Addresses

Primary practice location

Carr 185 KM 02 VRB Zona Industrial
Canoranas, PR 00729

Mailing address

PO Box 10000
Suite 572
Canoranas, PR 00729
Phone (787) 256-3592

Other identifiers 1

IdentifierTypeStateIssuer
4020424OtherNCPDP

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215026349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10000",
            "address_2": "SUITE 572",
            "city": "CANORANAS",
            "state": "PR",
            "postal_code": "00729",
            "telephone_number": "787-256-3592",
            "fax_number": "787-256-0172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 185 KM 02 VRB ZONA INDUSTRIAL",
            "city": "CANORANAS",
            "state": "PR",
            "postal_code": "00729",
            "telephone_number": "787-256-3592",
            "fax_number": "787-256-0172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARMACIA MEDINA #4 INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MEDINA",
        "authorized_official_first_name": "IRELISSE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "787-256-3592",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PR",
            "license": "07F2296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4020424",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.