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General NPI Number Information
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NPI Number | 1992668446
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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 | 12/03/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 20501 SENECA MEADOWS PKWY STE 120
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City | GERMANTOWN
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State | MD
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Zip | 20876-7017
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Country | US
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Telephone | 877-885-1101
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Fax | 877-885-1103
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Provider Business Mailing Address
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Address Line | 310 INTEGRITY DR
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City | MADISON
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State | WI
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Zip | 53717-1450
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Country | US
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Telephone | 877-885-1101
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Fax |
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Authorized Official
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Title or Position | CHIEF PHARMACY OFFICER
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Name | SHARON FAUST
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Credential |
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Telephone | 608-310-1811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty 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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