Provider Demographics
NPI:1518202266
Name:CUMBERBATCH, LEAH A (PHARMD)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:A
Last Name:CUMBERBATCH
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 1:1701 E COLTER ST UNIT 109
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-3369
Mailing Address - Country:US
Mailing Address - Phone:832-385-2103
Mailing Address - Fax:
Practice Address - Street 1:2345 E BASELINE RD
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-2326
Practice Address - Country:US
Practice Address - Phone:480-892-4978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-06
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARS019581183500000X
TX52579183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist