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LACEY FOLSOM
>> Pharmacist >> Pharmacy Service ProvidersRegistrant NPI Number: 1629479720
Individual Registrant: LACEY FOLSOM
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
4057 STATE HIGHWAY 3 STAR LAKE, NY 13690-3172 US
Tel: 315-848-3784 Fax: 315-848-5129
Tel: 315-848-3784 Fax: 315-848-5129
Contact information for business:
PO BOX 211 STAR LAKE, NY 13690-0211 US
Tel: 315-848-3784 Fax: 315-848-5129
Tel: 315-848-3784 Fax: 315-848-5129
Registration Information:
NPI: 1629479720
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 183500000X | Pharmacy Service Providers Pharmacist | NY | I 20 050800 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
