Provider Demographics
NPI:1578629515
Name:WINDSCHILL, PAUL R (RPH)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:R
Last Name:WINDSCHILL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 1ST AVE S
Mailing Address - Street 2:
Mailing Address - City:SAINT JAMES
Mailing Address - State:MN
Mailing Address - Zip Code:56081-1723
Mailing Address - Country:US
Mailing Address - Phone:507-375-8115
Mailing Address - Fax:507-375-8357
Practice Address - Street 1:418 1ST AVE S
Practice Address - Street 2:
Practice Address - City:SAINT JAMES
Practice Address - State:MN
Practice Address - Zip Code:56081-1726
Practice Address - Country:US
Practice Address - Phone:507-375-4511
Practice Address - Fax:507-375-7487
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN113112-7183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN538857100Medicaid
MN538857100Medicaid