Provider Demographics
NPI:1205125879
Name:LEAP, MEGAN MARIE (PHARM D)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:MARIE
Last Name:LEAP
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:MARIE
Other - Last Name:BOEHMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:74 JOSHUA M FREEMAN BLVD
Mailing Address - Street 2:
Mailing Address - City:RANSON
Mailing Address - State:WV
Mailing Address - Zip Code:25438-5694
Mailing Address - Country:US
Mailing Address - Phone:304-728-7713
Mailing Address - Fax:304-728-7766
Practice Address - Street 1:74 JOSHUA M FREEMAN BLVD
Practice Address - Street 2:
Practice Address - City:RANSON
Practice Address - State:WV
Practice Address - Zip Code:25438-5694
Practice Address - Country:US
Practice Address - Phone:304-728-7713
Practice Address - Fax:304-728-7766
Is Sole Proprietor?:No
Enumeration Date:2011-04-04
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0007195183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist