Stacey M Thacker, PHARM D
NPI #1962659664 in Edwardsville, Illinois
Provider Information
- NPI Number
- 1962659664
- Entity Type
- Individual
- Name
- Stacey M Thacker, PHARM D
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Clinic/Center - Primary Care
- Credential
- PHARM D
- Enumeration Date
- Aug 25, 2008
- Last Updated
- Aug 25, 2008
Practice Location
- Address
- 200 UNIVERSITY PARK DR
- Address 2
- CAMPUS BOX 2000
- City
- Edwardsville
- State
- Illinois
- ZIP Code
- 62026-0001
- Phone
- (618) 650-5131
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Primary Care — Primary Care |
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