Provider Demographics
NPI:1154421345
Name:PEREZ MENENDEZ HNOS INC
Entity type:Organization
Organization Name:PEREZ MENENDEZ HNOS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:PEREZ
Authorized Official - Last Name:CORDOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-785-0767
Mailing Address - Street 1:AS52 CALLE 37
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956-4742
Mailing Address - Country:US
Mailing Address - Phone:787-785-0767
Mailing Address - Fax:787-995-0327
Practice Address - Street 1:AS52 CALLE 37
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956-4742
Practice Address - Country:US
Practice Address - Phone:787-785-0767
Practice Address - Fax:787-995-0327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07S2181333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR5619990001Medicare ID - Type Unspecified