Organization
LEATH & LEATH INC
Active
Other names
Leath Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK CORNELIUS LEATH PHARMD. (PHARMACY MANAGER)
(772) 461-6330
Entity
Organization
Contact information
Practice address
1727 OKEECHOBEE RD, FORT PIERCE, FL 34950-3945
(772) 461-6330
(772) 461-1798
Mailing address
1727 OKEECHOBEE RD, FORT PIERCE, FL 34950-3945
(772) 461-6330
(772) 461-1798
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PH9856
FL
3336C0003X
Community/Retail Pharmacy
Primary
PH9856
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109697400
—
FL
Enumeration date
10/27/2006
Last updated
01/23/2009
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