Provider Demographics
NPI:1417058652
Name:LEFFLER, JOHN (RPH)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:LEFFLER
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 1:108 WYNNGATE RD
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31410-4113
Mailing Address - Country:US
Mailing Address - Phone:912-897-4979
Mailing Address - Fax:912-691-3517
Practice Address - Street 1:1326 EISENHOWER DR
Practice Address - Street 2:BUILDING #1
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3928
Practice Address - Country:US
Practice Address - Phone:912-691-3528
Practice Address - Fax:912-691-3517
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH11112183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist