Provider Demographics
NPI:1932141926
Name:LOCKE, MARCIA M (RPH)
Entity Type:Individual
Prefix:
First Name:MARCIA
Middle Name:M
Last Name:LOCKE
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 1:78 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CLIFTON SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:14432-1145
Mailing Address - Country:US
Mailing Address - Phone:315-462-9264
Mailing Address - Fax:
Practice Address - Street 1:78 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CLIFTON SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:14432-1145
Practice Address - Country:US
Practice Address - Phone:315-462-9264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY28726183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist