Provider Demographics
NPI:1578700464
Name:BEATTY, LEIGH ALLISON (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LEIGH
Middle Name:ALLISON
Last Name:BEATTY
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 1:515 COX RD
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-0628
Mailing Address - Country:US
Mailing Address - Phone:704-867-5343
Mailing Address - Fax:704-864-1499
Practice Address - Street 1:515 COX RD
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-0628
Practice Address - Country:US
Practice Address - Phone:704-867-5343
Practice Address - Fax:704-864-1499
Is Sole Proprietor?:No
Enumeration Date:2009-01-14
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18351183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist