Provider Demographics
NPI:1669487203
Name:LEANDER PHARMACY
Entity Type:Organization
Organization Name:LEANDER PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:JACK
Authorized Official - Middle Name:
Authorized Official - Last Name:ADKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-930-5168
Mailing Address - Street 1:2701 S HIGHWAY 183
Mailing Address - Street 2:STE C
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-2300
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2701 S HIGHWAY 183
Practice Address - Street 2:STE C
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-2300
Practice Address - Country:US
Practice Address - Phone:512-836-6378
Practice Address - Fax:512-259-8086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX146603336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4584199OtherOTHER ID NUMBER-COMMERCIAL NUMBER