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NPI Code Detail

MEDICARE: DR. LEAH MICHELE BOARDWINE PHARM.D.

MEDICARE: DR. LEAH MICHELE BOARDWINE PHARM.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist0202209377VA

General Provider Information

NPI Number : 1245532035
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LEAH MICHELE BOARDWINE PHARM.D.
Provider Business Mailing Address
First Line : 4488 ELECTRIC RD
Second Line :
City : ROANOKE
State : VA
Zip : 24018-0722
Country : US
Telephone Number : 540-989-4448
Fax Number : 540-776-1460
Provider Business Practice Location Address
First Line : 4488 ELECTRIC RD
Second Line :
City : ROANOKE
State : VA
Zip : 24018-0722
Country : US
Telephone Number : 540-989-4448
Fax Number : 540-776-1460
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2010
Last Update Date : 11/30/2010

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