Lacey Dunkley Freeman I, PHARMD
Individual provider Active NPI Pharmacist · Waverly, TN
NPI 1114421237 · NPPES record last updated Mar 22, 2018
Key facts
- NPI
- 1114421237
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 41225 (TN)
- Practice address
- 275 Walton Dr
Waverly, TN 37185-3382 - Phone
- (931) 296-9984
- Fax
- (931) 296-1935
- NPI assigned
- Mar 22, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wal-Mart Stores East LP | Past | Accepting new patients | |
| Wal-Mart Stores East, LP | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 41225 | TN | Yes |
Addresses
Primary practice location
275 Walton Dr
Waverly, TN 37185-3382
Mailing address
275 Walton Dr
Waverly, TN 37185-3382
Phone (931) 296-9984
Other providers in Waverly, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 22, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.