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General NPI Number Information
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NPI Number | 1164722609
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Entity Type | Individual
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Provider Name | LEIGH LAFOON PHARMD
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Gender | Female
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Dates
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Enumeration Date | 11/01/2010
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Last Update Date | 05/04/2012
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Provider Practice Location Address
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Address Line | 4600 MAIN ST STE 2
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City | SHALLOTTE
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State | NC
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Zip | 28470-1899
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Country | US
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Telephone | 910-754-7570
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Fax | 910-754-4828
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Provider Business Mailing Address
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Address Line | 4600 MAIN ST STE 2
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City | SHALLOTTE
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State | NC
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Zip | 28470-1899
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Country | US
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Telephone | 910-754-7570
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Fax | 910-754-4828
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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 | 21138
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License Number State | NC
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