Provider Demographics
NPI:1487936076
Name:LEECH, KARI
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:
Last Name:LEECH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E MCMURRAY RD
Mailing Address - Street 2:
Mailing Address - City:MC MURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-2928
Mailing Address - Country:US
Mailing Address - Phone:724-949-1583
Mailing Address - Fax:724-949-1589
Practice Address - Street 1:100 E MCMURRAY RD
Practice Address - Street 2:
Practice Address - City:MC MURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-2928
Practice Address - Country:US
Practice Address - Phone:724-949-1583
Practice Address - Fax:724-949-1589
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP444063183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist