Provider Demographics
NPI:1104170612
Name:LUMI PHARMACY LLC
Entity type:Organization
Organization Name:LUMI PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KETTY
Authorized Official - Middle Name:
Authorized Official - Last Name:DE ARMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-888-6755
Mailing Address - Street 1:261 WESTWARD DR
Mailing Address - Street 2:SUITE 108-109
Mailing Address - City:MIAMI SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33166-5290
Mailing Address - Country:US
Mailing Address - Phone:305-888-6755
Mailing Address - Fax:305-888-9722
Practice Address - Street 1:261 WESTWARD DR
Practice Address - Street 2:SUITE 108-109
Practice Address - City:MIAMI SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33166-5290
Practice Address - Country:US
Practice Address - Phone:305-888-6755
Practice Address - Fax:305-888-9722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-06
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH264243336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPH26424OtherRETAIL COMMUNITY