Provider Demographics
NPI:1922117639
Name:LUCAS, ALLISON GILLESPIE (RPH)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:GILLESPIE
Last Name:LUCAS
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 1:641 WINESAP RD
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24019-8416
Mailing Address - Country:US
Mailing Address - Phone:540-966-3230
Mailing Address - Fax:540-992-3273
Practice Address - Street 1:40 SUMMERS WAY
Practice Address - Street 2:SUITE 101
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24019-8286
Practice Address - Country:US
Practice Address - Phone:540-966-4858
Practice Address - Fax:540-992-3273
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202011048183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist