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Contact Information

SAM LEAKE LLC
105 HEARTHSTONE DR
GRAY COURT, SC29645
 Phone: 864-360-3697
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for SAM LEAKE LLC

NPI Number 1427786680
LBN Legal business name SAM LEAKE LLC
Authorized official SAMUEL LEAKE - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 08/15/2022
Last updated 11/25/2022 - About 4 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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