Organization
LUNA PHARMACY AT MADISON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMMAD KHAMIS (PRESIDENT)
(773) 353-5047
Entity
Organization
Contact information
Practice address
3171 W MADISON ST STE 2, CHICAGO, IL 60612-1809
(773) 435-9905
(773) 340-4435
Mailing address
3171 W MADISON ST STE 2, CHICAGO, IL 60612-1809
(773) 435-9905
(773) 340-4435
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
01/04/2019
Last updated
01/04/2019
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