Provider Demographics
NPI:1346611837
Name:CAPDEVILLE, LEANN (PHARMD)
Entity Type:Individual
Prefix:
First Name:LEANN
Middle Name:
Last Name:CAPDEVILLE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 5TH AVE STE B
Mailing Address - Street 2:PO BOX 631
Mailing Address - City:HAVRE
Mailing Address - State:MT
Mailing Address - Zip Code:59501-3623
Mailing Address - Country:US
Mailing Address - Phone:406-265-9601
Mailing Address - Fax:406-265-4422
Practice Address - Street 1:123 5TH AVE STE B
Practice Address - Street 2:
Practice Address - City:HAVRE
Practice Address - State:MT
Practice Address - Zip Code:59501-3623
Practice Address - Country:US
Practice Address - Phone:406-265-9601
Practice Address - Fax:406-265-4422
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-09
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT12402183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist