# LEACH PHARMACIES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LEACH PHARMACIES, LLC
- **Other names:** Crestline Pharmacy LTC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1295590784
- **Legal business name:** LEACH PHARMACIES, LLC
- **Authorized official:** MATTHEW SCOTT LEACH (OWNER)
- **Authorized official phone:** (205) 871-0317

## Contact information

- **Practice address:** 60 CHURCH ST, MOUNTAIN BRK, AL 35213-3794
- **Practice address phone:** (205) 871-0317
- **Practice address fax:** (205) 871-9756
- **Mailing address:** 60 CHURCH ST, MOUNTAIN BRK, AL 35213-3794
- **Mailing address phone:** (205) 871-0317
- **Mailing address fax:** (205) 871-9756

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 02/14/2024
- **Last updated:** 02/14/2024