Provider Demographics
NPI:1184352171
Name:LEACH, STANLEY M (RPH)
Entity type:Individual
Prefix:MR
First Name:STANLEY
Middle Name:M
Last Name:LEACH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-1628
Mailing Address - Country:US
Mailing Address - Phone:859-623-8900
Mailing Address - Fax:859-623-8901
Practice Address - Street 1:238 E MAIN ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-1628
Practice Address - Country:US
Practice Address - Phone:859-623-8900
Practice Address - Fax:859-623-8901
Is Sole Proprietor?:No
Enumeration Date:2022-08-09
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY006888183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist