Provider Demographics
NPI:1730649310
Name:CHAPMAN, LACEY (RPH)
Entity Type:Individual
Prefix:
First Name:LACEY
Middle Name:
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 GLENN ST STE 300
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-2590
Mailing Address - Country:US
Mailing Address - Phone:844-773-6779
Mailing Address - Fax:
Practice Address - Street 1:217 GLENN ST STE 300
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-2590
Practice Address - Country:US
Practice Address - Phone:844-773-6779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-21
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25361183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist