Individual
MATTHEW LACEFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPHT
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
600107010292385
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1063675684
HUMANA PHARMACY
—
Enumeration date
08/04/2022
Last updated
08/04/2022
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