Provider Demographics
NPI:1417232687
Name:LELEUX, MICHAEL H (RPH)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:H
Last Name:LELEUX
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 1:100 EDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71360-5441
Mailing Address - Country:US
Mailing Address - Phone:318-448-0962
Mailing Address - Fax:
Practice Address - Street 1:100 EDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71360-5441
Practice Address - Country:US
Practice Address - Phone:318-448-0962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9265183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist