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NPI Code Detail

MEDICARE: DR. JENNIFER ANNE LECHEVALIER PHARMD, RPH

MEDICARE: DR. JENNIFER ANNE LECHEVALIER PHARMD, RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist2010033603MO
2183500000XPharmacist018688KY
3183500000XPharmacist051.294529IL
4183500000XPharmacistRP00008998NM
5183500000XPharmacist40829TN

General Provider Information

NPI Number : 1013284223
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIFER ANNE LECHEVALIER PHARMD, RPH
Provider Business Mailing Address
First Line : 1247 EMERSON AVE
Second Line :
City : EDWARDSVILLE
State : IL
Zip : 62025-2302
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2100 MADISON AVE
Second Line :
City : GRANITE CITY
State : IL
Zip : 62040-4713
Country : US
Telephone Number : 618-798-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2011
Last Update Date : 08/01/2021

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