Provider Demographics
NPI:1336877737
Name:BUAYA, LOREWELL DAGDAYAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LOREWELL
Middle Name:DAGDAYAN
Last Name:BUAYA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 18TH AVE APT 8
Mailing Address - Street 2:
Mailing Address - City:UNION GROVE
Mailing Address - State:WI
Mailing Address - Zip Code:53182-1809
Mailing Address - Country:US
Mailing Address - Phone:630-401-5541
Mailing Address - Fax:
Practice Address - Street 1:819 N MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53404-3270
Practice Address - Country:US
Practice Address - Phone:262-637-4900
Practice Address - Fax:262-637-7148
Is Sole Proprietor?:No
Enumeration Date:2022-08-12
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI21398-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist