Provider Demographics
NPI:1255117149
Name:WINDERLIN, PAIGE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:PAIGE
Middle Name:
Last Name:WINDERLIN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:PAIGE
Other - Middle Name:
Other - Last Name:WILKE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:180 CLUB DR
Mailing Address - Street 2:
Mailing Address - City:SCOTT CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67871-4148
Mailing Address - Country:US
Mailing Address - Phone:620-872-7243
Mailing Address - Fax:
Practice Address - Street 1:102 ALBERT AVE
Practice Address - Street 2:
Practice Address - City:SCOTT CITY
Practice Address - State:KS
Practice Address - Zip Code:67871-7102
Practice Address - Country:US
Practice Address - Phone:620-872-2146
Practice Address - Fax:620-872-7099
Is Sole Proprietor?:No
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-107290183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist