Provider Demographics
NPI:1184041618
Name:G.A. LUCAS ENTERPRISES, PS
Entity Type:Organization
Organization Name:G.A. LUCAS ENTERPRISES, PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INCORPORATOR
Authorized Official - Prefix:
Authorized Official - First Name:GWEN
Authorized Official - Middle Name:A,
Authorized Official - Last Name:LUCAS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:509-202-6596
Mailing Address - Street 1:5008 N VISTA VIEW CIR
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99212-1665
Mailing Address - Country:US
Mailing Address - Phone:509-202-6596
Mailing Address - Fax:
Practice Address - Street 1:5008 N VISTA VIEW CIR
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99212-1665
Practice Address - Country:US
Practice Address - Phone:509-202-6596
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-21
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN 00153966251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care