Provider Demographics
NPI:1053425397
Name:LEONARDS PHARMACY, INC.
Entity type:Organization
Organization Name:LEONARDS PHARMACY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST-IN-CHARGE
Authorized Official - Prefix:MR
Authorized Official - First Name:DON
Authorized Official - Middle Name:C
Authorized Official - Last Name:FINKENBINDER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:432-267-1611
Mailing Address - Street 1:1501 W 11TH PL STE 106
Mailing Address - Street 2:
Mailing Address - City:BIG SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:79720-4122
Mailing Address - Country:US
Mailing Address - Phone:432-267-1611
Mailing Address - Fax:432-267-4237
Practice Address - Street 1:1501 W 11TH PL STE 106
Practice Address - Street 2:
Practice Address - City:BIG SPRING
Practice Address - State:TX
Practice Address - Zip Code:79720-4122
Practice Address - Country:US
Practice Address - Phone:432-267-1611
Practice Address - Fax:432-267-4237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00959332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX110253Medicaid
TX110253Medicaid