Healthcare Provider Details

I. General information

NPI: 1205159845
Provider Name (Legal Business Name): RAE ANN LECH PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2010
Last Update Date: 03/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

153 STEWART RD
HANOVER TOWNSHIP PA
18706-1486
US

IV. Provider business mailing address

153 STEWART RD
HANOVER TOWNSHIP PA
18706-1486
US

V. Phone/Fax

Practice location:
  • Phone: 570-821-0842
  • Fax: 570-821-0855
Mailing address:
  • Phone: 570-821-0842
  • Fax: 570-821-0855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License NumberRP440265
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: