Provider Demographics
NPI:1043557929
Name:LACOMBE, JOSEPH E (RPH)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:E
Last Name:LACOMBE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1291 S SUMTER BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH PORT
Mailing Address - State:FL
Mailing Address - Zip Code:34287-2337
Mailing Address - Country:US
Mailing Address - Phone:941-426-6955
Mailing Address - Fax:941-423-4335
Practice Address - Street 1:1291 S. SUMTER BLVD
Practice Address - Street 2:
Practice Address - City:NORTH PORT
Practice Address - State:FL
Practice Address - Zip Code:34287
Practice Address - Country:US
Practice Address - Phone:941-426-6955
Practice Address - Fax:941-426-4335
Is Sole Proprietor?:No
Enumeration Date:2013-01-11
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0024034183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist