Russell, Leslie W

Russell, Leslie W is an individual health care provider with primary practice located at 415 S 42Nd St , Mount Vernon IL 62864-6266. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Russell, Leslie W can be contacted via phone (618) 244-9660.

Contact Information

Primary practice address
415 S 42Nd St Mount Vernon IL 62864-6266
Phone: (618) 244-9660
Fax: (618) 244-9551
Website:
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Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X Illinois

Profile Details

NPI number 1275526782
LBN Legal business name Russell, Leslie W
Credentials R . PH.
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2005
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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