Provider Demographics
NPI:1295012466
Name:LILDARLIN INVESTMENTS INC
Entity type:Organization
Organization Name:LILDARLIN INVESTMENTS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WIAFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-458-2222
Mailing Address - Street 1:4640 NADENA DR
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33872-1779
Mailing Address - Country:US
Mailing Address - Phone:863-458-2222
Mailing Address - Fax:863-658-2730
Practice Address - Street 1:1542 LAKEVIEW DR STE 1
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-7957
Practice Address - Country:US
Practice Address - Phone:863-385-2200
Practice Address - Fax:863-385-2225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-15
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 332B00000X
FLPH256463336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
2132752OtherPK