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General NPI Number Information
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NPI Number | 1316748270
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Entity Type | Organization
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Legal Business Name | LUX BOX RX
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Dates
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Enumeration Date | 03/24/2025
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 2821 GLENWOOD AVE 61107
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City | ROCKFORD
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State | IL
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Zip | 61103
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Country | US
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Telephone | 508-736-2599
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Fax |
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Provider Business Mailing Address
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Address Line | 2821 GLENWOOD AVE
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City | ROCKFORD
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State | IL
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Zip | 61103
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Country | US
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Telephone | 508-736-2599
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. LUCIE DONIKIAN
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Credential | BCPC, PHARMD
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Telephone | 508-736-2599
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care 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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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