Active NPI
Marjorie Laciak, PHARMD
- Pharmacist
- Valparaiso, IN
National Provider Identifier
1699060988
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 26020771A
- Practice address
- 1001 Sturdy Rd
Valparaiso, IN 46383-4126 - Phone
- (219) 465-9505
- Fax
- (219) 465-9519
- NPI assigned
- Jun 14, 2011
- Last updated
- Dec 8, 2020
- 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 | 26020771A | IN | Primary |
Addresses
Primary practice location
1001 Sturdy Rd
Valparaiso, IN 46383-4126
Mailing address
1001 Sturdy Rd
Valparaiso, IN 46383-4126
Phone (219) 465-9505
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26020771A | IN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Scholl Pharmacy Inc | Current | Accepting new patients | |
| Fagen Pharmacy 15 | Current | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607385600000",
"number": "1699060988",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1001 STURDY RD",
"city": "VALPARAISO",
"state": "IN",
"postal_code": "463834126",
"telephone_number": "219-465-9505",
"fax_number": "219-465-9519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 STURDY RD",
"city": "VALPARAISO",
"state": "IN",
"postal_code": "463834126",
"telephone_number": "219-465-9505",
"fax_number": "219-465-9519"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LACIAK",
"first_name": "MARJORIE",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-14",
"last_updated": "2020-12-08",
"certification_date": "2020-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IN",
"license": "26020771A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Valparaiso, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.