Individual
TIMOTHY LEE LACEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BS PD
Contact information
Practice address
518 CLAY ST, ARKADELPHIA, AR 71923-6024
(501) 217-8880
Mailing address
2502 E CARMICHAEL RD, CABOT, AR 72023-9609
(501) 231-1130
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
PD07030
AR
Other
Enumeration date
10/20/2023
Last updated
10/20/2023
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