NPIMap

Organization Active NPI

Leach Pharmacies, LLC

Doing business as Crestline Pharmacy LTC

  • Long Term Care Pharmacy
  • Mountain BRK, AL
National Provider Identifier
1659446458
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
LEACH PHARMACIES, LLC
Doing business as
Crestline Pharmacy LTC
Practice address
60 Church St
Mountain BRK, AL 35213-3794
Phone
(205) 871-0317
Fax
(205) 871-9756
NPI assigned
Nov 21, 2006
Last updated
Feb 14, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Matthew Scott Leach, PHARMDNPI 1679737878
Title
Owner
Phone
(205) 871-0317

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 102890 AL
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

60 Church St
Mountain BRK, AL 35213-3794

Mailing address

60 Church Street
Birmingham, AL 35213
Phone (205) 871-0317

Other names 1

  • Crestline Pharmacy LTC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Leach Pharmacies LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707868800000",
    "number": "1659446458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 CHURCH STREET",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35213",
            "telephone_number": "205-871-0317",
            "fax_number": "205-871-9756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 CHURCH ST",
            "city": "MOUNTAIN BRK",
            "state": "AL",
            "postal_code": "352133794",
            "telephone_number": "205-871-0317",
            "fax_number": "205-871-9756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEACH PHARMACIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A",
        "authorized_official_last_name": "LEACH",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "205-871-0317",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AL",
            "license": "102890",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crestline Pharmacy LTC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mountain BRK, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.