Healthcare Provider Details

I. General information

NPI: 1811999634
Provider Name (Legal Business Name): LESTER LACHUK PHARM.D., MBA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2005
Last Update Date: 08/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2935 COLONIAL DR
COLUMBIA SC
29203-6811
US

IV. Provider business mailing address

2935 COLONIAL DR
COLUMBIA SC
29203-6811
US

V. Phone/Fax

Practice location:
  • Phone: 803-401-1343
  • Fax: 803-255-0261
Mailing address:
  • Phone: 803-401-1343
  • Fax: 803-255-0261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number10071
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: