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General NPI Number Information
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NPI Number | 1578919510
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Entity Type | Organization
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Legal Business Name | LEITERS ENTERPRISES INC
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Dates
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Enumeration Date | 05/09/2016
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Last Update Date | 07/19/2018
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Provider Practice Location Address
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Address Line | 6541 VIA DEL ORO STE B
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City | SAN JOSE
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State | CA
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Zip | 95119-1207
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Country | US
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Telephone | 408-326-1530
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Fax | 408-824-1368
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Provider Business Mailing Address
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Address Line | 6541 VIA DEL ORO STE B
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City | SAN JOSE
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State | CA
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Zip | 95119-1207
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Country | US
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Telephone | 408-326-1530
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Fax | 408-824-1368
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | ROBIN HOKE
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Credential | PHARM.D.
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Telephone | 408-292-6772
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | PHY54652
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License Number State | CA
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