Provider Demographics
NPI:1467556415
Name:LEHMAN'S PHARMACY LLC
Entity Type:Organization
Organization Name:LEHMAN'S PHARMACY LLC
Other - Org Name:LEHMANS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:LEHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:217-253-5878
Mailing Address - Street 1:716 S RANDOLPH ST STE A
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61820-8315
Mailing Address - Country:US
Mailing Address - Phone:217-253-5878
Mailing Address - Fax:217-253-3238
Practice Address - Street 1:716 S RANDOLPH ST STE A
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61820-8315
Practice Address - Country:US
Practice Address - Phone:217-253-5878
Practice Address - Fax:217-253-3238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
IL054.0199883336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL371406539001Medicaid
2020983OtherPK
4291320001Medicare NSC