Leah M Mauritz, RPH

Individual provider Active NPI Pharmacist · Fountain Inn, SC

NPI 1902155641 · NPPES record last updated Sep 7, 2012

Key facts

NPI
1902155641
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
7465 (SC)
Practice address
203 N. Main St.
Fountain Inn, SC 29644
Phone
(864) 862-4414
NPI assigned
Sep 7, 2012
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
7465SCMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 7465 SC Yes

Addresses

Primary practice location

203 N. Main St.
Fountain Inn, SC 29644

Mailing address

203 N. Main St.
Fountain Inn, SC 29644
Phone (864) 862-4414

Other providers in Fountain Inn, SC

All providers in Fountain Inn, SC · Pharmacist in South Carolina

Sources for this page

Verify at the official NPI Registry.