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NPI Code Detail

MEDICARE: DR. LEANNA M MINER RPH

MEDICARE: DR. LEANNA M MINER RPH
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
1183500000XPharmacistRPH-0017010OR
21835P2201XAmbulatory Care PharmacistRPH-0017010OR

General Provider Information

NPI Number : 1619430063
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LEANNA M MINER RPH
Provider Business Mailing Address
First Line : 530 SUMMERVIEW DR
Second Line :
City : STAYTON
State : OR
Zip : 97383-1397
Country : US
Telephone Number : 631-848-9242
Fax Number :
Provider Business Practice Location Address
First Line : 3169 CRATER LAKE HWY
Second Line :
City : MEDFORD
State : OR
Zip : 97504-9179
Country : US
Telephone Number : 541-774-4346
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2019
Last Update Date : 02/09/2024

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