# DAYTON MALL FOODS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CUB PHARMACY 609
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053487694
- **Authorized official:** MIKE LOFINO (PRESIDENT)
- **Authorized official phone:** (937) 431-1662

## Contact information

- **Practice address:** 8245 SPRINGBORO PIKE, MIAMISBURG, OH 45342-6103
- **Practice address phone:** (937) 434-5778
- **Practice address fax:** (937) 434-0545
- **Mailing address:** 8245 SPRINGBORO PIKE, MIAMISBURG, OH 45342-6103
- **Mailing address phone:** (937) 439-0452
- **Mailing address fax:** (937) 434-0545

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | RTP020941000 | OH | Yes |

## Other

- **Enumeration date:** 11/27/2006
- **Last updated:** 04/25/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0271147 | — | OH |
| 01 | — | 3662459 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |