Provider Demographics
NPI:1952443533
Name:LYDIA E. LAUREANO MENA
Entity Type:Organization
Organization Name:LYDIA E. LAUREANO MENA
Other - Org Name:FARMACIA MENAA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:LYDIA
Authorized Official - Middle Name:LAUREANO
Authorized Official - Last Name:MENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-753-7356
Mailing Address - Street 1:271 AVE BARBOSA
Mailing Address - Street 2:ESQ DUARTE
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00917-3310
Mailing Address - Country:US
Mailing Address - Phone:787-753-7356
Mailing Address - Fax:787-767-8100
Practice Address - Street 1:271 AVE BARBOSA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-3310
Practice Address - Country:US
Practice Address - Phone:787-753-7356
Practice Address - Fax:787-767-8100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07F20713336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4018900OtherNABP
PR4018900OtherNABP