Provider Demographics
NPI:1326320862
Name:DREW, LEONARD (RPH)
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:
Last Name:DREW
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 1:392 BEDFORD ST
Mailing Address - Street 2:
Mailing Address - City:WHITMAN
Mailing Address - State:MA
Mailing Address - Zip Code:02382-1822
Mailing Address - Country:US
Mailing Address - Phone:781-447-0823
Mailing Address - Fax:781-447-8315
Practice Address - Street 1:392 BEDFORD ST
Practice Address - Street 2:
Practice Address - City:WHITMAN
Practice Address - State:MA
Practice Address - Zip Code:02382-1822
Practice Address - Country:US
Practice Address - Phone:781-447-0823
Practice Address - Fax:781-447-8315
Is Sole Proprietor?:No
Enumeration Date:2011-09-11
Last Update Date:2011-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH23407183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist