Provider Demographics
NPI:1689803108
Name:COLEMAN, LENORE THREADGILL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LENORE
Middle Name:THREADGILL
Last Name:COLEMAN
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 1:6809 WILLOW CREEK RD
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-3327
Mailing Address - Country:US
Mailing Address - Phone:301-805-4516
Mailing Address - Fax:301-577-1655
Practice Address - Street 1:6809 WILLOW CREEK RD
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-3327
Practice Address - Country:US
Practice Address - Phone:301-805-4516
Practice Address - Fax:301-577-1655
Is Sole Proprietor?:No
Enumeration Date:2009-07-06
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL333371835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy