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Organization

F.E. LESLIE DRUGGIST, INC.

Active
Other names
leslies drug, LESLIE'S PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID WARREN HOLMBERG CPHT-ADV (STORE MANAGER / CPHT-ADV)
(508) 693-1010
Entity
Organization

Contact information

Practice address
65 MAIN ST, VINEYARD HAVEN, MA 02568-5402
(508) 693-1010
(508) 693-6229
Mailing address
PO BOX 417, VINEYARD HAVEN, MA 02568-0417
(508) 693-1010
(508) 693-6229

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
3302
MA
3336C0003X
Community/Retail Pharmacy
Primary
3302
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0495611
MA
01
2216275
NCPDP
MA
Enumeration date
08/02/2006
Last updated
12/15/2021
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