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NPI Code Detail

MEDICARE: MR. EDWARD GAETON LEAKE R.PH.

MEDICARE:  MR. EDWARD GAETON LEAKE  R.PH.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist18783NC

General Provider Information

NPI Number : 1518128677
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. EDWARD GAETON LEAKE R.PH.
Provider Business Mailing Address
First Line : 300 MARKET ST STE 114
Second Line :
City : CHAPEL HILL
State : NC
Zip : 27516-4493
Country : US
Telephone Number : 919-240-4084
Fax Number : 919-724-4568
Provider Business Practice Location Address
First Line : 300 MARKET ST STE 114
Second Line :
City : CHAPEL HILL
State : NC
Zip : 27516-4493
Country : US
Telephone Number : 919-240-4084
Fax Number : 919-724-4568
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2008
Last Update Date : 10/29/2024

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Directions to “ MR. EDWARD GAETON LEAKE R.PH.” Practice Location

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