MEDICARE: DR. MICHAEL BARTHOLOMEW LACON PHARMD

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	RP449624	PA

General Provider Information

NPI Number	:	1922471275
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL BARTHOLOMEW LACON PHARMD

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	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/09/2015
Last Update Date	:	11/09/2015

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