Provider Demographics
NPI:1063012573
Name:LUCAS, KAYLA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KAYLA
Middle Name:
Last Name:LUCAS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 160
Mailing Address - Street 2:
Mailing Address - City:LUDLOW
Mailing Address - State:MA
Mailing Address - Zip Code:01056-0160
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:742 MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTH OXFORD
Practice Address - State:MA
Practice Address - Zip Code:01537-1148
Practice Address - Country:US
Practice Address - Phone:508-987-1111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH238318183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist