MEDICARE: LACON'S PHARMACY, INC.

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	183500000X	Pharmacist	PP413756L	PA
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821189440
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LACON'S PHARMACY, INC.

Provider Business Mailing Address
First Line	:	1336 POWELL ST
Second Line	:
City	:	NORRISTOWN
State	:	PA
Zip	:	19401-3324
Country	:	US
Telephone Number	:	610-279-0140
Fax Number	:	610-279-5767

Provider Business Practice Location Address
First Line	:	1336 POWELL ST
Second Line	:
City	:	NORRISTOWN
State	:	PA
Zip	:	19401-3324
Country	:	US
Telephone Number	:	610-279-0140
Fax Number	:	610-279-5767

Authorized Official
Title or Position	:	PRESIDENT/ PHARMACIST
Name	:	MR. MICHAEL LACON
Credential	:
Telephone Number	:	610-279-0140

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	04/14/2022

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