Organization
SAM LEAKE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL NATHAN LEAKE PHARM.D. (OWNER)
(864) 360-3697
Entity
Organization
Contact information
Practice address
105 HEARTHSTONE DR, GRAY COURT, SC 29645
(864) 360-3697
Mailing address
105 HEARTHSTONE DR, GRAY COURT, SC 29645
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
08/15/2022
Last updated
11/25/2022
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