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General NPI Number Information
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NPI Number | 1205054764
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Entity Type | Individual
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Provider Name | LEONA CLAIRE PYLE RPH
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Gender | Female
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2013 W BROADWAY AVE
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City | FOREST LAKE
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State | MN
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Zip | 55025-9373
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Country | US
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Telephone | 651-982-4503
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Fax |
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Provider Business Mailing Address
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Address Line | 146 PALOMINO LN
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City | LINO LAKES
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State | MN
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Zip | 55014-2913
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Country | US
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Telephone | 651-784-4947
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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 | 112191
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 3789
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License Number State | SD
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