Organization
LUNA PHARMACY AT SOUTH SHORE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMMAD KHAMIS (PRESIDENT)
(773) 353-5047
Entity
Organization
Contact information
Practice address
1952 E 73RD ST, CHICAGO, IL 60649-2902
(773) 493-4444
Mailing address
5352 N LINCOLN AVE, CHICAGO, IL 60625-2316
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
10/29/2018
Last updated
10/29/2018
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