Provider Demographics
NPI:1780284042
Name:LUCAS, DAVID C (RPH)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:C
Last Name:LUCAS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 OAKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-3240
Mailing Address - Country:US
Mailing Address - Phone:724-349-5759
Mailing Address - Fax:724-465-9403
Practice Address - Street 1:3100 OAKLAND AVE STE 1C
Practice Address - Street 2:
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-3277
Practice Address - Country:US
Practice Address - Phone:724-349-5759
Practice Address - Fax:724-465-9403
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP039074L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist