Provider Demographics
NPI:1891090601
Name:LE S FAMILY PHARMACY
Entity Type:Organization
Organization Name:LE S FAMILY PHARMACY
Other - Org Name:LE'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-207-3267
Mailing Address - Street 1:1600 PURSER DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-2935
Mailing Address - Country:US
Mailing Address - Phone:980-207-3267
Mailing Address - Fax:980-207-3268
Practice Address - Street 1:1600 PURSER DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-2935
Practice Address - Country:US
Practice Address - Phone:980-207-3267
Practice Address - Fax:980-207-3268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-26
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NC108843336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0602561Medicaid
2128485OtherPK