Provider Demographics
NPI:1063832947
Name:KANE, LEIGH ANN (RPH)
Entity Type:Individual
Prefix:
First Name:LEIGH
Middle Name:ANN
Last Name:KANE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 N POINT PKWY
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-3006
Mailing Address - Country:US
Mailing Address - Phone:770-521-1788
Mailing Address - Fax:678-514-8029
Practice Address - Street 1:6000 N POINT PKWY
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-3006
Practice Address - Country:US
Practice Address - Phone:770-521-1788
Practice Address - Fax:678-514-8029
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-18
Last Update Date:2014-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH016481183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist