MEDICARE: ELIZABETH TALLIS LEANDER PHARMD

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
1	183500000X	Pharmacist	PR70222	ME
2	183500000X	Pharmacist	0011778	CT

General Provider Information

NPI Number	:	1659882868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH TALLIS LEANDER PHARMD

Provider Business Mailing Address
First Line	:	1060 BROADWAY
Second Line	:
City	:	SOUTH PORTLAND
State	:	ME
Zip	:	04106-5724
Country	:	US
Telephone Number	:	413-579-1565
Fax Number	:

Provider Business Practice Location Address
First Line	:	65 GRAY RD
Second Line	:
City	:	FALMOUTH
State	:	ME
Zip	:	04105-2057
Country	:	US
Telephone Number	:	207-878-0050
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/14/2017
Last Update Date	:	12/08/2025

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