Provider Demographics
NPI:1831309210
Name:LEBOEUF, JOAN MARIE (RPH, MS)
Entity Type:Individual
Prefix:
First Name:JOAN MARIE
Middle Name:
Last Name:LEBOEUF
Suffix:
Gender:F
Credentials:RPH, MS
Other - Prefix:
Other - First Name:JOAN MARIE
Other - Middle Name:
Other - Last Name:ST. DENIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH, MS
Mailing Address - Street 1:674 SHAKER HILL RD
Mailing Address - Street 2:
Mailing Address - City:ENFIELD
Mailing Address - State:NH
Mailing Address - Zip Code:03748-3627
Mailing Address - Country:US
Mailing Address - Phone:603-632-5967
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03756-1000
Practice Address - Country:US
Practice Address - Phone:603-650-5593
Practice Address - Fax:603-650-4454
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHR1742183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist