Provider Demographics
NPI:1952503914
Name:CUMMINGS, LEIGH BOSTON (DPH)
Entity Type:Individual
Prefix:MRS
First Name:LEIGH
Middle Name:BOSTON
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:622 W MARKET ST STE 200
Mailing Address - Street 2:
Mailing Address - City:BOLIVAR
Mailing Address - State:TN
Mailing Address - Zip Code:38008-2241
Mailing Address - Country:US
Mailing Address - Phone:731-658-3973
Mailing Address - Fax:731-658-5870
Practice Address - Street 1:622 W MARKET ST STE 200
Practice Address - Street 2:
Practice Address - City:BOLIVAR
Practice Address - State:TN
Practice Address - Zip Code:38008-2241
Practice Address - Country:US
Practice Address - Phone:731-658-3973
Practice Address - Fax:731-658-5870
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9345183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist