Organization
LUNA PHARMACY LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AIMAN ALANFOUS (PRESIDENT)
(773) 435-9902
Entity
Organization
Contact information
Practice address
5352 N LINCOLN AVE, CHICAGO, IL 60625-2316
(773) 435-9902
(773) 435-9003
Mailing address
5352 N LINCOLN AVE, CHICAGO, IL 60625-2316
(773) 435-9902
(773) 435-9903
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
054.018025
IL
332BC3200X
Customized Equipment (DME)
054.018025
IL
332BX2000X
Oxygen Equipment & Supplies (DME)
054.018025
IL
333600000X
Pharmacy
054.018025
IL
3336C0003X
Community/Retail Pharmacy
Primary
054.018025
IL
3336C0004X
Compounding Pharmacy
054.018025
IL
335G00000X
Medical Foods Supplier
054.018025
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1487594
NCPDP
IL
Enumeration date
11/19/2012
Last updated
07/30/2014
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