Provider Demographics
NPI:1285069286
Name:GALLAGHER, LACEE LEA (PHARMD)
Entity type:Individual
Prefix:
First Name:LACEE
Middle Name:LEA
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 VILLAGE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-3603
Mailing Address - Country:US
Mailing Address - Phone:719-548-1477
Mailing Address - Fax:
Practice Address - Street 1:840 VILLAGE CENTER DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-3603
Practice Address - Country:US
Practice Address - Phone:719-548-1477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-09
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO20087183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist