Provider Demographics
NPI:1285422204
Name:LUKE PILL LLC
Entity type:Organization
Organization Name:LUKE PILL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:BOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIDAROUS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:501-604-8008
Mailing Address - Street 1:901 JOHN BARROW RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6503
Mailing Address - Country:US
Mailing Address - Phone:717-319-4033
Mailing Address - Fax:501-604-8009
Practice Address - Street 1:901 JOHN BARROW RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6503
Practice Address - Country:US
Practice Address - Phone:717-319-4033
Practice Address - Fax:501-604-8009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy