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General NPI Number Information
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NPI Number | 1235580697
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Entity Type | Organization
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Legal Business Name | LUMICERA HEALTH SERVICES LLC
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Dates
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Enumeration Date | 06/28/2016
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 9185 E PIMA CENTER PKWY STE 200
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-4646
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Country | US
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Telephone | 855-847-3553
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Fax | 855-847-3558
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Provider Business Mailing Address
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Address Line | 9185 E PIMA CENTER PKWY STE 200
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-4646
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Country | US
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Telephone | 855-847-3553
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Fax | 855-847-3558
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | PETER NIELSON
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Credential |
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Telephone | 608-310-1837
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | Y006807
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License Number State | AZ
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