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LACEY DRUG COMPANY INC NPI 1023123825


NPI Information

NPI: 1023123825
Provider Name: LACEY DRUG COMPANY INC

Doing Business As: LACEYS LTC PHARMACY

Classification: Pharmacy - 3336L0003X
Entity Type: Organization

Specialization: Long Term Care Pharmacy

CLIA Number: 11D1101867

Address:
4469 LEMON ST
ACWORTH, GA
ZIP 30101
Phone: (678) 236-0400
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LACEY DRUG COMPANY INC is a long term care pharmacy pharmacy in Acworth, GA. The provider is a pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. LACEY DRUG COMPANY INC NPI is 1023123825. The provider is registered as an organization entity type.
The provider Is Doing Business As Laceys Ltc Pharmacy.

The provider's business location address is:

4469 LEMON ST
ACWORTH, GA
ZIP 30101-418
Phone: (678) 236-0400
Fax: (678) 236-0404

The provider's authorized official is Bennie Flanagan .
The authorized official title is V-p and has the following contact phone number (678) 236-0400.

The CLIA number assigned to this NPI record is 11D1101867 - industrial with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/20/2006 and was last updated on 9/14/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1333600000XPharmacyNo
23336L0003XPharmacyLong Term Care PharmacyPHRE008914GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12015785OTHERPK
20216650001MEDICARE NSC
330357CMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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