Provider Demographics
NPI:1437607900
Name:LEARY, LISA MARIE (PHARM D)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:MARIE
Last Name:LEARY
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:MARIE
Other - Last Name:LAYMAN LEARY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:42 SPRING FELLOW LN
Mailing Address - Street 2:
Mailing Address - City:TAYLORS
Mailing Address - State:SC
Mailing Address - Zip Code:29687-1714
Mailing Address - Country:US
Mailing Address - Phone:530-921-0313
Mailing Address - Fax:
Practice Address - Street 1:211 INGLES PL
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29678-0848
Practice Address - Country:US
Practice Address - Phone:864-882-8066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-14
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC36766183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist