Provider Demographics
NPI:1033721246
Name:MILLS, LEAH R (RPH)
Entity type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:R
Last Name:MILLS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:903 BENHAM ST
Mailing Address - Street 2:
Mailing Address - City:BONNE TERRE
Mailing Address - State:MO
Mailing Address - Zip Code:63628-1305
Mailing Address - Country:US
Mailing Address - Phone:573-358-3311
Mailing Address - Fax:573-358-7971
Practice Address - Street 1:903 BENHAM ST
Practice Address - Street 2:
Practice Address - City:BONNE TERRE
Practice Address - State:MO
Practice Address - Zip Code:63628-1305
Practice Address - Country:US
Practice Address - Phone:573-358-3311
Practice Address - Fax:573-358-7971
Is Sole Proprietor?:No
Enumeration Date:2020-08-19
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO044719183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist