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General NPI Number Information
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NPI Number | 1649526781
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Entity Type | Individual
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Provider Name | JAMES DAVID LEISTER JR. PHARMD
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Gender | Male
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Dates
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Enumeration Date | 07/26/2012
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Last Update Date | 07/26/2012
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Provider Practice Location Address
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Address Line | 955 CONGRESS PARK DR
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City | DAYTON
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State | OH
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Zip | 45459-4009
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Country | US
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Telephone | 937-428-7970
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Fax |
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Provider Business Mailing Address
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Address Line | 8377 ISLAND LN
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City | MAINEVILLE
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State | OH
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Zip | 45039-9537
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Country | US
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Telephone | 513-515-1931
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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 | 03132316-1
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License Number State | OH
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