Provider Demographics
NPI:1235862319
Name:DUMLIGHT PHARMACY LLC
Entity Type:Organization
Organization Name:DUMLIGHT PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOFFERIAN
Authorized Official - Middle Name:JAQUEIL
Authorized Official - Last Name:AMBEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-678-8703
Mailing Address - Street 1:3535 GULF FWY # 3515
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:TX
Mailing Address - Zip Code:77539-4120
Mailing Address - Country:US
Mailing Address - Phone:281-678-8703
Mailing Address - Fax:832-442-5377
Practice Address - Street 1:3535 GULF FWY # 3515
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:TX
Practice Address - Zip Code:77539-4120
Practice Address - Country:US
Practice Address - Phone:281-678-8703
Practice Address - Fax:832-442-5377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-06
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy