| NPI | 1902982622 |
|---|---|
| Doing Business As | LEATH PHARMACY |
| Entity Type | Organization |
| Authorized Contact | MARK CORNELIUS LEATH Pharmacy Manager 772-461-6330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: FL PH9856) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL PH9856) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2009-01-23 |