Provider Demographics
NPI:1306094263
Name:LEGALLEE, WILLIAM H (PHARMD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:H
Last Name:LEGALLEE
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 1:12524 COOPERS LN
Mailing Address - Street 2:
Mailing Address - City:WORTON
Mailing Address - State:MD
Mailing Address - Zip Code:21678-1351
Mailing Address - Country:US
Mailing Address - Phone:314-809-6710
Mailing Address - Fax:314-485-2297
Practice Address - Street 1:9036 JUNCTION DR
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS JUNCTION
Practice Address - State:MD
Practice Address - Zip Code:20701-1130
Practice Address - Country:US
Practice Address - Phone:314-281-6734
Practice Address - Fax:314-485-2297
Is Sole Proprietor?:No
Enumeration Date:2008-09-04
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0005509183500000X
PARP455193183500000X
DCPH100003900183500000X
IL051-293458183500000X
FLPS44762183500000X
MD27076183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist