Provider Demographics
NPI:1841213337
Name:PHILLIPPE, LEIGH R (RPH)
Entity Type:Individual
Prefix:
First Name:LEIGH
Middle Name:R
Last Name:PHILLIPPE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1227 COBB RD
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28501-9597
Mailing Address - Country:US
Mailing Address - Phone:252-520-6717
Mailing Address - Fax:252-523-3497
Practice Address - Street 1:1302 W VERNON AVE
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28504-3528
Practice Address - Country:US
Practice Address - Phone:252-523-6069
Practice Address - Fax:252-523-3497
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16211183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist