Provider Demographics
NPI:1033318480
Name:MONROE, LEIGHTON OSBORNE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LEIGHTON
Middle Name:OSBORNE
Last Name:MONROE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2653 DANZANTE PL
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28306-9365
Mailing Address - Country:US
Mailing Address - Phone:910-425-5158
Mailing Address - Fax:
Practice Address - Street 1:7701 S RAEFORD RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-6130
Practice Address - Country:US
Practice Address - Phone:910-864-6675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-16
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16938183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist