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General NPI Number Information
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NPI Number | 1003911355
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Entity Type | Organization
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Legal Business Name | LEECH DRUG CO INC
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 02/20/2008
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Provider Practice Location Address
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Address Line | 109 DREW ST
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City | STAR CITY
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State | AR
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Zip | 71667-0479
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Country | US
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Telephone | 870-628-4263
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Fax | 870-628-4926
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Provider Business Mailing Address
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Address Line | 109 DREW ST PO BOX 479
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City | STAR CITY
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State | AR
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Zip | 71661
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROBERT LEECH
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Credential |
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Telephone | 820-628-4263
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | AR06214
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License Number State | AR
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