Provider Demographics
NPI:1427272327
Name:CLAY, LACY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LACY
Middle Name:
Last Name:CLAY
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 1:24520 GREEN SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24211
Mailing Address - Country:US
Mailing Address - Phone:276-676-2405
Mailing Address - Fax:
Practice Address - Street 1:736 NORTH BEAVER DAM ROAD
Practice Address - Street 2:
Practice Address - City:DAMASCUS
Practice Address - State:VA
Practice Address - Zip Code:24236
Practice Address - Country:US
Practice Address - Phone:276-475-3688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202206239183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist