Provider Demographics
NPI:1639350291
Name:COX, LELAND GORDON JR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LELAND
Middle Name:GORDON
Last Name:COX
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1913 E FIRE TOWER RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-4126
Mailing Address - Country:US
Mailing Address - Phone:252-355-3538
Mailing Address - Fax:252-758-3324
Practice Address - Street 1:1913 E FIRE TOWER RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-4126
Practice Address - Country:US
Practice Address - Phone:252-355-3538
Practice Address - Fax:252-758-3324
Is Sole Proprietor?:No
Enumeration Date:2007-11-23
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19096183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist