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General NPI Number Information
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NPI Number | 1154666808
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Entity Type | Individual
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Provider Name | LEELA B PRAKASH R. PH
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Gender | Female
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Dates
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Enumeration Date | 12/06/2012
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Last Update Date | 12/06/2012
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Provider Practice Location Address
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Address Line | 215 PERRY HILL RD
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City | MONTGOMERY
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State | AL
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Zip | 36109-3725
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Country | US
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Telephone | 334-272-4670
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Fax |
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Provider Business Mailing Address
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Address Line | 370 RED OAK CT
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City | AUBURN
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State | AL
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Zip | 36832-6709
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Country | US
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Telephone | 334-821-1511
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 12944
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License Number State | AL
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