Healthcare Provider Details

I. General information

NPI: 1841890811
Provider Name (Legal Business Name): LEAH P PIATT PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/29/2020
Last Update Date: 10/29/2020
Certification Date: 10/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 SAINT ROBERT BLVD
SAINT ROBERT MO
65584-3311
US

IV. Provider business mailing address

185 SAINT ROBERT BLVD
SAINT ROBERT MO
65584-3311
US

V. Phone/Fax

Practice location:
  • Phone: 573-336-4323
  • Fax: 573-336-3762
Mailing address:
  • Phone: 573-336-4323
  • Fax: 573-336-3762

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2009025148
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: