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General NPI Number Information
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NPI Number | 1235014945
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Entity Type | Individual
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Provider Name | PAUL WCAHTER RPH
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Gender | Male
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Dates
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Enumeration Date | 08/11/2025
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 154 W MAIN ST
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City | LENA
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State | IL
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Zip | 61048-9247
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Country | US
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Telephone | 815-369-4111
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Fax | 815-369-2602
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Provider Business Mailing Address
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Address Line | PO BOX 434
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City | LENA
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State | IL
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Zip | 61048-0434
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Country | US
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Telephone | 815-369-4111
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Fax | 815-369-2602
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 051036809
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License Number State | IL
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