Healthcare Provider Details

I. General information

NPI: 1629088828
Provider Name (Legal Business Name): JULIE ELAINE LEGG PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W 12TH AVE
COLUMBUS OH
43210-1214
US

IV. Provider business mailing address

8289 DANBRIDGE WAY
WESTERVILLE OH
43082-7954
US

V. Phone/Fax

Practice location:
  • Phone: 614-292-0580
  • Fax: 614-292-1335
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03-2-19618
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: