Provider Demographics
NPI:1194779587
Name:BRIGMON, LELIA R (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LELIA
Middle Name:R
Last Name:BRIGMON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 SAN SALVADOR DR
Mailing Address - Street 2:
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29841-3509
Mailing Address - Country:US
Mailing Address - Phone:803-640-9141
Mailing Address - Fax:803-278-3306
Practice Address - Street 1:1 FREEDOM WAY
Practice Address - Street 2:VAMC- MH&GERIATRICS 263
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30904-6258
Practice Address - Country:US
Practice Address - Phone:706-733-0188
Practice Address - Fax:706-731-7164
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS238801835P1300X
SC0105941835P1300X
FL37201835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric
No1835G0303XPharmacy Service ProvidersPharmacistGeriatric