Provider Demographics
NPI:1407296924
Name:LECHS WINOLA PHARMACY INC
Entity Type:Organization
Organization Name:LECHS WINOLA PHARMACY INC
Other - Org Name:LECHS WINOLA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:LECH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-378-1000
Mailing Address - Street 1:PO BOX 453
Mailing Address - Street 2:
Mailing Address - City:LAKE WINOLA
Mailing Address - State:PA
Mailing Address - Zip Code:18625-0453
Mailing Address - Country:US
Mailing Address - Phone:570-378-1000
Mailing Address - Fax:570-378-2012
Practice Address - Street 1:1088 SR 307 STE 2
Practice Address - Street 2:
Practice Address - City:FACTORYVILLE
Practice Address - State:PA
Practice Address - Zip Code:18419-7877
Practice Address - Country:US
Practice Address - Phone:570-378-1000
Practice Address - Fax:570-378-2012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-28
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP4823803336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2141127OtherPK
PA1012478650001Medicaid