Organization
SUGARCREEK PLAZA FOODS LLC
Active
Other names
CUB PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE LOFINO RPH (PRESIDENT)
(937) 431-1662
Entity
Organization
Contact information
Practice address
6134 WILMINGTON PIKE, CENTERVILLE, OH 45459-7029
(937) 848-6691
(937) 848-3666
Mailing address
6134 WASHINGTON PIKE, CENTERVILLE, OH 45459
(937) 848-4600
(937) 848-3666
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
RTP020940850
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0287194
—
OH
01
—
3662461
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/27/2006
Last updated
03/30/2012
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