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NPI Code Detail

MEDICARE: LACY AND COMPANY

MEDICARE: LACY AND COMPANY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1305S00000XPoint of Service066110LGBGA

General Provider Information

NPI Number : 1265593446
Entity Type Code : Organization
Provider Name (Legal Business Name) : LACY AND COMPANY
Provider Business Mailing Address
First Line : 1420 FOXHALL LANE #8
Second Line :
City : ATLANTA
State : GA
Zip : 30316-3474
Country : US
Telephone Number : 404-328-0999
Fax Number : 404-328-0999
Provider Business Practice Location Address
First Line : 1420 FOXHALL LN SE APT 8
Second Line :
City : ATLANTA
State : GA
Zip : 30316-3474
Country : US
Telephone Number : 404-328-0999
Fax Number : 404-328-0999
Authorized Official
Title or Position : ICWP CASE MANAGER
Name : MS. CAROLYN LACY
Credential : CWM
Telephone Number : 404-328-0999
Provider Enumeration Date : 12/12/2006
Last Update Date : 08/22/2020

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Directions to “LACY AND COMPANY ” Practice Location

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