Provider Demographics
NPI:1801946272
Name:LEIGHTON PHARMACY, INC
Entity type:Organization
Organization Name:LEIGHTON PHARMACY, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:DALTON
Authorized Official - Last Name:LOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:BS PHARM
Authorized Official - Phone:256-389-9900
Mailing Address - Street 1:500 S MONTGOMERY AVENUE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:SHEFFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35660-3853
Mailing Address - Country:US
Mailing Address - Phone:256-389-9900
Mailing Address - Fax:256-389-9096
Practice Address - Street 1:500 S MONTGOMERY AVENUE
Practice Address - Street 2:SUITE 108
Practice Address - City:SHEFFIELD
Practice Address - State:AL
Practice Address - Zip Code:35660-3858
Practice Address - Country:US
Practice Address - Phone:256-389-9900
Practice Address - Fax:256-389-9096
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LEIGHTON PHARMACY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10500183500000X
AL8045183500000X
AL112477333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes333600000XSuppliersPharmacy
No183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL112477OtherSTATE BOARD OF PHARMACY
AL100003550Medicaid
ALBL8711930OtherDEA#
BL8711930OtherDEA
AL100003550Medicaid
AL112477OtherSTATE BOARD OF PHARMACY