Provider Demographics
NPI:1336425933
Name:LOGSDON, MARGIE LYN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARGIE
Middle Name:LYN
Last Name:LOGSDON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31564 GRAPE ST
Mailing Address - Street 2:
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92532-9700
Mailing Address - Country:US
Mailing Address - Phone:951-245-5732
Mailing Address - Fax:951-471-3762
Practice Address - Street 1:31564 GRAPE ST
Practice Address - Street 2:
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92532-9700
Practice Address - Country:US
Practice Address - Phone:951-245-5732
Practice Address - Fax:951-471-3762
Is Sole Proprietor?:No
Enumeration Date:2011-10-26
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39858183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist