Provider Demographics
NPI:1205832672
Name:EDLOE, LEONARD LEVI (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:LEVI
Last Name:EDLOE
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 1:6044 TURKEY HOLLOW PL
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-6963
Mailing Address - Country:US
Mailing Address - Phone:804-781-0317
Mailing Address - Fax:804-781-0317
Practice Address - Street 1:1124 N 25TH ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223-5256
Practice Address - Country:US
Practice Address - Phone:804-643-5721
Practice Address - Fax:804-644-5301
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202004323183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist