Healthcare Provider Details

I. General information

NPI: 1710899893
Provider Name (Legal Business Name): TRACY LACY RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 S 3RD ST
GADSDEN AL
35901-5304
US

IV. Provider business mailing address

148 GREENBRIAR RD
GADSDEN AL
35901-6424
US

V. Phone/Fax

Practice location:
  • Phone: 256-543-5500
  • Fax:
Mailing address:
  • Phone: 256-441-0115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number13261
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: