Provider Demographics
NPI:1528056009
Name:SARGENT, LUCAS R (PHARMD, CGP)
Entity type:Individual
Prefix:DR
First Name:LUCAS
Middle Name:R
Last Name:SARGENT
Suffix:
Gender:M
Credentials:PHARMD, CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:695 LOXLEY LN
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-7801
Mailing Address - Country:US
Mailing Address - Phone:937-524-2449
Mailing Address - Fax:
Practice Address - Street 1:8264 W STATE ROUTE 41
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:OH
Practice Address - Zip Code:45318-1248
Practice Address - Country:US
Practice Address - Phone:800-232-4239
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-2-25077183500000X, 1835P1200X
MI5302034066183500000X, 1835P1200X
IN26021012A183500000X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy