Provider Demographics
NPI:1245230739
Name:ALLEN, LEIGH MASSEY (PHARM D, BCACP, BCGP)
Entity Type:Individual
Prefix:
First Name:LEIGH
Middle Name:MASSEY
Last Name:ALLEN
Suffix:
Gender:F
Credentials:PHARM D, BCACP, BCGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 ROBERTA CT.
Mailing Address - Street 2:GREAT OAKS PHARMACY
Mailing Address - City:BISHOP
Mailing Address - State:GA
Mailing Address - Zip Code:30621
Mailing Address - Country:US
Mailing Address - Phone:706-255-2357
Mailing Address - Fax:
Practice Address - Street 1:920 HIGHWAY 138 NW
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:GA
Practice Address - Zip Code:30655-7702
Practice Address - Country:US
Practice Address - Phone:770-266-0278
Practice Address - Fax:770-207-9056
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL50010183500000X
SC11574183500000X
GA022147183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist