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General NPI Number Information
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NPI Number | 1780741983
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Entity Type | Organization
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Legal Business Name | LEESBURG REGIONAL MEDICAL CENTER INC
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 08/15/2024
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Provider Practice Location Address
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Address Line | 600 E DIXIE AVE OUTPATIENT PHARMACY ROOM 1046
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City | LEESBURG
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State | FL
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Zip | 34748-5925
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Country | US
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Telephone | 352-323-5384
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Fax | 352-315-3679
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Provider Business Mailing Address
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Address Line | 600 E. DIXIE AVENUE ATTN: REIMBURSEMENT DEPT.
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City | LEESBURG
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State | FL
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Zip | 34748-5994
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Country | US
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Telephone | 352-323-5380
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Fax | 352-315-5384
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Authorized Official
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Title or Position | CEO
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Name | HEATHER B. LONG
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Credential |
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Telephone | 352-323-5001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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