MEDICARE: LEAH K SEEHUSEN PHARMACIST

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
1	183500000X	Pharmacist	115654-2	MN
2	183500000X	Pharmacist	45734	TX

General Provider Information

NPI Number	:	1598797680
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEAH K SEEHUSEN PHARMACIST

Provider Business Mailing Address
First Line	:	5425 S PADRE ISLAND DR
Second Line	:	SUITE D
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78411-5301
Country	:	US
Telephone Number	:	361-980-8979
Fax Number	:	361-980-8979

Provider Business Practice Location Address
First Line	:	5425 S PADRE ISLAND DR
Second Line	:	SUITE D
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78411-5301
Country	:	US
Telephone Number	:	361-980-8979
Fax Number	:	361-980-8979

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	07/19/2011

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Directions to “ LEAH K SEEHUSEN PHARMACIST” Practice Location

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