Healthcare Provider Details

I. General information

NPI: 1467556415
Provider Name (Legal Business Name): LEHMAN'S PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 02/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

716 S RANDOLPH ST STE A
CHAMPAIGN IL
61820-8315
US

IV. Provider business mailing address

716 S RANDOLPH ST STE A
CHAMPAIGN IL
61820-8315
US

V. Phone/Fax

Practice location:
  • Phone: 217-253-5878
  • Fax: 217-253-3238
Mailing address:
  • Phone: 217-253-5878
  • Fax: 217-253-3238

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number054.019988
License Number StateIL

VIII. Authorized Official

Name: TODD LEHMAN
Title or Position: OWNER/PHARMACIST IN CHARGE
Credential: RPH
Phone: 217-253-5878