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General NPI Number Information
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NPI Number | 1760790166
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Entity Type | Organization
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Legal Business Name | LEIGHTON PHARMACY, INC
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Dates
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Enumeration Date | 09/20/2010
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Last Update Date | 05/16/2013
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Provider Practice Location Address
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Address Line | 15190 COURT ST. SUITE A
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City | MOULTON
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State | AL
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Zip | 35650-1519
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Country | US
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Telephone | 256-974-1770
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Fax | 256-974-1709
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Provider Business Mailing Address
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Address Line | 15190 COURT ST. SUITE A
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City | MOULTON
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State | AL
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Zip | 35650-0000
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Country | US
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Telephone | 256-974-1770
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Fax | 256-974-1709
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RODNEY DALTON LOGAN
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Credential | R. PH.
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Telephone | 256-974-1770
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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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