Provider Demographics
NPI:1154644896
Name:MIGLIORE, LEONARD A (RPH)
Entity Type:Individual
Prefix:MR
First Name:LEONARD
Middle Name:A
Last Name:MIGLIORE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4457 STATE ROUTE 38 NE
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:OH
Mailing Address - Zip Code:43140-9681
Mailing Address - Country:US
Mailing Address - Phone:740-857-1548
Mailing Address - Fax:
Practice Address - Street 1:238 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:OH
Practice Address - Zip Code:43140-9059
Practice Address - Country:US
Practice Address - Phone:740-852-0878
Practice Address - Fax:740-852-3469
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03310194183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist