Provider Demographics
NPI:1154633097
Name:KANE, LUANNE LAMASTER (RPH)
Entity Type:Individual
Prefix:MRS
First Name:LUANNE
Middle Name:LAMASTER
Last Name:KANE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 NOB HILL DR
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22556-1615
Mailing Address - Country:US
Mailing Address - Phone:540-752-1509
Mailing Address - Fax:
Practice Address - Street 1:12154 DARNESTOWN RD
Practice Address - Street 2:#518
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-2206
Practice Address - Country:US
Practice Address - Phone:301-926-7666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-08
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA020200618183500000X
IN26013335A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist