Provider Demographics
NPI:1366738551
Name:LACHELT, JEFF ALLAN (PHARM D)
Entity type:Individual
Prefix:DR
First Name:JEFF
Middle Name:ALLAN
Last Name:LACHELT
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 KENYON RD
Mailing Address - Street 2:TRMC
Mailing Address - City:FORT DODGE
Mailing Address - State:IA
Mailing Address - Zip Code:50501-2972
Mailing Address - Country:US
Mailing Address - Phone:515-574-6696
Mailing Address - Fax:
Practice Address - Street 1:802 KENYON RD
Practice Address - Street 2:PHARMACY
Practice Address - City:FORT DODGE
Practice Address - State:IA
Practice Address - Zip Code:50501-2972
Practice Address - Country:US
Practice Address - Phone:515-574-6696
Practice Address - Fax:515-574-6696
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-26
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA20148183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist