MEDICARE: DR. LEANN LEA PHARMD

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	PD11580	AR
2	183500000X	Pharmacist	14719	OK

General Provider Information

NPI Number	:	1790308849
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEANN LEA PHARMD

Provider Business Mailing Address
First Line	:	2425 S ZERO ST
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72901-8663
Country	:	US
Telephone Number	:	479-646-4983
Fax Number	:

Provider Business Practice Location Address
First Line	:	2425 S ZERO ST
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72901-8663
Country	:	US
Telephone Number	:	479-646-4983
Fax Number	:

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

Provider Enumeration Date	:	05/23/2020
Last Update Date	:	11/27/2023

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Directions to “ DR. LEANN LEA PHARMD” Practice Location

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