Provider Demographics
NPI:1104366202
Name:LO-CAL PHARMA LLC
Entity Type:Organization
Organization Name:LO-CAL PHARMA LLC
Other - Org Name:LOCAL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHADY
Authorized Official - Middle Name:
Authorized Official - Last Name:ARAFA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:513-757-9019
Mailing Address - Street 1:4075 E GALBRAITH RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-2323
Mailing Address - Country:US
Mailing Address - Phone:513-757-9019
Mailing Address - Fax:513-757-9020
Practice Address - Street 1:4075 E GALBRAITH RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2323
Practice Address - Country:US
Practice Address - Phone:513-757-9019
Practice Address - Fax:513-757-9020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-08
Last Update Date:2018-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH228129003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH314144Medicaid