Healthcare Provider Details

I. General information

NPI: 1205707247
Provider Name (Legal Business Name): EZRI LEIGH MCMASTER CPHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2025
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 TAYLOR RD
MONTGOMERY AL
36117-3512
US

IV. Provider business mailing address

400 TAYLOR RD
MONTGOMERY AL
36117-3511
US

V. Phone/Fax

Practice location:
  • Phone: 334-277-8330
  • Fax:
Mailing address:
  • Phone: 334-277-8330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License NumberT68658
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License NumberPTEC.VA.70057126
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: