MEDICARE: STACY L LACLAIRE PHARRMD

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
1	1835X0200X	Oncology Pharmacist	440601	CO

General Provider Information

NPI Number	:	1578419701
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STACY L LACLAIRE PHARRMD

Provider Business Mailing Address
First Line	:	893 SHADOW MOUNTAIN DR
Second Line	:
City	:	HIGHLANDS RANCH
State	:	CO
Zip	:	80126-2135
Country	:	US
Telephone Number	:	720-922-3207
Fax Number	:

Provider Business Practice Location Address
First Line	:	893 SHADOW MOUNTAIN DR
Second Line	:
City	:	HIGHLANDS RANCH
State	:	CO
Zip	:	80126-2135
Country	:	US
Telephone Number	:	720-987-3301
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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