Adam Paul Lucas, PHARM D
Individual provider Active NPI Pharmacist · Stanwood, MI
NPI 1366720252 · NPPES record last updated Jul 27, 2011
Key facts
- NPI
- 1366720252
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 5302038118 (MI)
- Practice address
- 11632 Riverside Dr
Stanwood, MI 49346-9562 - Phone
- (231) 852-4401
- NPI assigned
- Jul 27, 2011
- Sex
- Male
- Sole proprietor
- Yes
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302038118 | MI | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302038118 | MI | Yes |
Addresses
Primary practice location
11632 Riverside Dr
Stanwood, MI 49346-9562
Mailing address
11632 Riverside Dr
Stanwood, MI 49346-9562
Phone (231) 852-4401
Other providers in Stanwood, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 27, 2011. 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.