Healthcare Provider Details

I. General information

NPI: 1124958830
Provider Name (Legal Business Name): PAUL LUNGU
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3569 RIDGE RD
CLEVELAND OH
44102-5443
US

IV. Provider business mailing address

3569 RIDGE RD
CLEVELAND OH
44102-5443
US

V. Phone/Fax

Practice location:
  • Phone: 216-281-0872
  • Fax:
Mailing address:
  • Phone: 216-281-0872
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03443798
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: