Provider Demographics
NPI:1730241886
Name:LEQUIRE, MITCHELL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:
Last Name:LEQUIRE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 WORLEY RD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NC
Mailing Address - Zip Code:27569-8333
Mailing Address - Country:US
Mailing Address - Phone:919-936-3218
Mailing Address - Fax:
Practice Address - Street 1:601 N 8TH ST
Practice Address - Street 2:SUITE D
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-4119
Practice Address - Country:US
Practice Address - Phone:919-934-2111
Practice Address - Fax:919-934-2814
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15483183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist