Provider Demographics
NPI:1205475175
Name:LORDONI DISCOUNT PHARMACY INC
Entity type:Organization
Organization Name:LORDONI DISCOUNT PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OLUGBENGA
Authorized Official - Middle Name:
Authorized Official - Last Name:ONI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-610-3114
Mailing Address - Street 1:PO BOX 411703
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32941-1703
Mailing Address - Country:US
Mailing Address - Phone:321-610-3114
Mailing Address - Fax:321-622-8609
Practice Address - Street 1:6300 N WICKHAM RD STE 126
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-2037
Practice Address - Country:US
Practice Address - Phone:321-610-3114
Practice Address - Fax:321-622-8609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-24
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy