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NPI Code Detail

MEDICARE: PAUL FRANCIS LEIBOLD R.PH.

MEDICARE:   PAUL FRANCIS LEIBOLD  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
1183500000XPharmacist19005OH

General Provider Information

NPI Number : 1780665562
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL FRANCIS LEIBOLD R.PH.
Provider Business Mailing Address
First Line : 1955 E FORK RD
Second Line :
City : NEW VIENNA
State : OH
Zip : 45159-9513
Country : US
Telephone Number : 937-382-6717
Fax Number : 937-383-2990
Provider Business Practice Location Address
First Line : 1150 W LOCUST ST
Second Line : SUITE 100
City : WILMINGTON
State : OH
Zip : 45177-2572
Country : US
Telephone Number : 937-382-6717
Fax Number : 937-383-2990
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2005
Last Update Date : 07/08/2007

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Directions to “ PAUL FRANCIS LEIBOLD R.PH.” Practice Location

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