Active NPI
Lacy Wade
- Pharmacist
- Memphis, TN
National Provider Identifier
1063794758
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 34301
- Practice address
- 3381 Poplar Ave
Memphis, TN 38111-4601 - Phone
- (901) 458-8559
- NPI assigned
- Sep 19, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 34301 | TN | Primary |
Addresses
Primary practice location
3381 Poplar Ave
Memphis, TN 38111-4601
Mailing address
3381 Poplar Ave
Memphis, TN 38111-4601
Phone (901) 458-8559
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316390400000",
"number": "1063794758",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3381 POPLAR AVE",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381114601",
"telephone_number": "901-458-8559"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3381 POPLAR AVE",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381114601",
"telephone_number": "901-458-8559"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WADE",
"first_name": "LACY",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-19",
"last_updated": "2011-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "34301",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.