John Ervin Leonard, R.PH

Individual provider Active NPI Pharmacist · Woodruff, SC

NPI 1962779546 · NPPES record last updated Nov 26, 2011

Key facts

NPI
1962779546
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
7802 (SC)
Practice address
371 S Main St
Woodruff, SC 29388-1867
Phone
(864) 476-2112
Fax
(864) 476-6012
NPI assigned
Nov 26, 2011
Sex
Male
Sole proprietor
No

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
11387NCMDGeneral Practice Dentistry
7802SCMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 7802 SC Yes
Pharmacist 183500000X 11387 NC

Addresses

Primary practice location

371 S Main St
Woodruff, SC 29388-1867

Mailing address

371 S Main St
Woodruff, SC 29388-1867
Phone (864) 476-2112

Other providers in Woodruff, SC

All providers in Woodruff, SC · Pharmacist in South Carolina

Sources for this page

Verify at the official NPI Registry.