Healthcare Provider Details

I. General information

NPI: 1538092523
Provider Name (Legal Business Name): LEIA GADDIS PHARMD
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1316 E 7TH ST
AUBURN IN
46706-2538
US

IV. Provider business mailing address

1316 E 7TH ST
AUBURN IN
46706-2538
US

V. Phone/Fax

Practice location:
  • Phone: 260-920-2694
  • Fax:
Mailing address:
  • Phone: 260-920-2694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26030544A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number70393
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: