Healthcare Provider Details

I. General information

NPI: 1730620584
Provider Name (Legal Business Name): LEAH R GREGORY PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LEAH N REINHARD PHARM.D.

II. Dates (important events)

Enumeration Date: 03/13/2017
Last Update Date: 08/17/2022
Certification Date: 08/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3525 E BATTLEFIELD ST
SPRINGFIELD MO
65809-3434
US

IV. Provider business mailing address

501 HIDDEN CREEK DR
OZARK MO
65721-4230
US

V. Phone/Fax

Practice location:
  • Phone: 417-269-1499
  • Fax:
Mailing address:
  • Phone: 417-268-8898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number2013024738
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number2013024738
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number15665
License Number StateOK
# 4
Primary TaxonomyN
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License NumberPD-13758
License Number StateAR
# 5
Primary TaxonomyN
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number1-16319
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: