Provider Demographics
NPI:1508461732
Name:LECKER, BRADY J (RPH)
Entity Type:Individual
Prefix:MR
First Name:BRADY
Middle Name:J
Last Name:LECKER
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:CVS/PHARMACY 04002
Mailing Address - Street 2:70 WEST STEUBEN STREET
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15205
Mailing Address - Country:US
Mailing Address - Phone:412-921-2060
Mailing Address - Fax:412-921-3079
Practice Address - Street 1:CVS/PHARMACY 04002
Practice Address - Street 2:70 WEST STEUBEN STREET
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15205
Practice Address - Country:US
Practice Address - Phone:412-921-2060
Practice Address - Fax:412-921-3079
Is Sole Proprietor?:No
Enumeration Date:2020-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP044006R183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist