Healthcare Provider Details

I. General information

NPI: 1922055995
Provider Name (Legal Business Name): LESLIE CAROL DURRANT R.PH
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 HOSPITAL DR
COLUMBIA MO
65201-5275
US

IV. Provider business mailing address

3721 N FORESTVIEW RD
COLUMBIA MO
65202-8449
US

V. Phone/Fax

Practice location:
  • Phone: 573-814-6000
  • Fax: 573-814-6536
Mailing address:
  • Phone: 573-447-3952
  • Fax: 573-814-6536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number5302029620
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: