Provider Demographics
NPI:1942614326
Name:LALUK, GENE NICHOLAS (RPH)
Entity Type:Individual
Prefix:
First Name:GENE
Middle Name:NICHOLAS
Last Name:LALUK
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:GENE
Other - Middle Name:NICHOLAS
Other - Last Name:LALUK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:15507 E TEPEE DR
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN HILLS
Mailing Address - State:AZ
Mailing Address - Zip Code:85268-1409
Mailing Address - Country:US
Mailing Address - Phone:480-862-2580
Mailing Address - Fax:
Practice Address - Street 1:16545 E PALISADES BLVD
Practice Address - Street 2:
Practice Address - City:FOUNTAIN HILLS
Practice Address - State:AZ
Practice Address - Zip Code:85268-3707
Practice Address - Country:US
Practice Address - Phone:480-836-8351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-13
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS06587183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist