Healthcare Provider Details

I. General information

NPI: 1760392278
Provider Name (Legal Business Name): LUIS OSMANLLI PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 W MAIN ST
MERIDEN CT
06451-2710
US

IV. Provider business mailing address

15 BRIARWOOD CIR
CHESHIRE CT
06410-2628
US

V. Phone/Fax

Practice location:
  • Phone: 203-237-8984
  • Fax:
Mailing address:
  • Phone: 203-715-9022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPCT.0017419
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: