Provider Demographics
NPI:1821189440
Name:LACON'S PHARMACY, INC.
Entity Type:Organization
Organization Name:LACON'S PHARMACY, INC.
Other - Org Name:LACON'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/ PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LACON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-279-0140
Mailing Address - Street 1:1336 POWELL ST
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19401-3324
Mailing Address - Country:US
Mailing Address - Phone:610-279-0140
Mailing Address - Fax:610-279-5767
Practice Address - Street 1:1336 POWELL ST
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19401-3324
Practice Address - Country:US
Practice Address - Phone:610-279-0140
Practice Address - Fax:610-279-5767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP413756L183500000X
332B00000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1038559Medicaid
PA1038559Medicaid