Provider Demographics
NPI:1316550940
Name:LEAD OFF 1 ENTERPRISES LLC
Entity Type:Organization
Organization Name:LEAD OFF 1 ENTERPRISES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-937-7237
Mailing Address - Street 1:742 CRABB RIVER RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-5608
Mailing Address - Country:US
Mailing Address - Phone:281-937-7237
Mailing Address - Fax:281-937-7625
Practice Address - Street 1:742 CRABB RIVER RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-5608
Practice Address - Country:US
Practice Address - Phone:281-937-7237
Practice Address - Fax:281-937-7625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy