Provider Demographics
NPI:1629673611
Name:LEONHARDT, ANDEW JACOB (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANDEW
Middle Name:JACOB
Last Name:LEONHARDT
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1108 VINSON CT
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40515-6293
Mailing Address - Country:US
Mailing Address - Phone:502-821-2687
Mailing Address - Fax:
Practice Address - Street 1:3097 TODDS RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1276
Practice Address - Country:US
Practice Address - Phone:859-266-3202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY019974183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist