Provider Demographics
NPI:1275731705
Name:PITTMAN, LEAH CAROLINE
Entity Type:Individual
Prefix:DR
First Name:LEAH
Middle Name:CAROLINE
Last Name:PITTMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 WARREN ST
Mailing Address - Street 2:CARRIAGE HOUSE
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29403-6577
Mailing Address - Country:US
Mailing Address - Phone:919-218-6080
Mailing Address - Fax:
Practice Address - Street 1:109 BEE ST
Practice Address - Street 2:DEPT 119
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29401-5703
Practice Address - Country:US
Practice Address - Phone:843-577-5011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18978183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist