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NPI Code Detail

MEDICARE: TIMOTHY HUGH LACEY R.PH.

MEDICARE: TIMOTHY HUGH LACEY R.PH.
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
1183500000XPharmacist9033AL

General Provider Information

NPI Number : 1508148495
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY HUGH LACEY R.PH.
Provider Business Mailing Address
First Line : 2101 RICHARD ARRINGTON JR BLVD S
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35209-1256
Country : US
Telephone Number : 205-939-1417
Fax Number : 205-939-4328
Provider Business Practice Location Address
First Line : 2101 RICHARD ARRINGTON JR BLVD S
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35209-1256
Country : US
Telephone Number : 205-939-1417
Fax Number : 205-939-4328
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2011
Last Update Date : 09/15/2011

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