Healthcare Provider Details

I. General information

NPI: 1407296924
Provider Name (Legal Business Name): LECHS WINOLA PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2013
Last Update Date: 07/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1088 SR 307 STE 2
FACTORYVILLE PA
18419-7877
US

IV. Provider business mailing address

PO BOX 453
LAKE WINOLA PA
18625-0453
US

V. Phone/Fax

Practice location:
  • Phone: 570-378-1000
  • Fax: 570-378-2012
Mailing address:
  • Phone: 570-378-1000
  • Fax: 570-378-2012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPP482380
License Number StatePA

VIII. Authorized Official

Name: JOSEPH LECH
Title or Position: MANAGING PARTNER
Credential:
Phone: 570-378-1000