JASON WAGGONER RPH
NPI 1033713524
Pharmacist in Mattoon, IL

Active since November 24, 2020
1316 CHARLESTON AVE, MATTOON, IL 61938(217) 258-2920 Get Directions Write a Review

NPPES record last updated: November 24, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Jason Waggoner Rph NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JASON WAGGONER RPH (NPI 1033713524) is an individual pharmacist in Mattoon, Illinois, licensed in Illinois (051-289951) and active in the NPI registry since November 2020.Information from the official NPPES registry record.

NPPES Registry Identity

NPI1033713524
Entity TypeIndividualMale
Primary Taxonomy183500000X
Provider Legal NameJASON WAGGONERCredential: RPH
Location Address1316 CHARLESTON AVEMattoon, IL 61938-4016
Mailing Address1316 Charleston AveMattoon, IL 61938-4016 · (217) 258-2920
Sole ProprietorNo
Enumeration DateNovember 24, 2020
NPPES CertifiedNovember 24, 2020
NPI 1033713524 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPharmacistPharmacy Service Providers
Taxonomy Code183500000X
License Licensed in IL · 051-289951
Definition

An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.

1316 CHARLESTON AVE, Mattoon, IL 61938

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Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Pharmacist
1316 CHARLESTON AVE
MATTOON, IL 61938
Pharmacist
1316 CHARLESTON AVE
MATTOON, IL 61938
Pharmacy
1316 CHARLESTON AVE
MATTOON, IL 61938

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1033713524, enumerated as an "individual" on November 24, 2020.

The provider is located at 1316 CHARLESTON AVE MATTOON, IL 61938 and the phone number is (217) 258-2920.

Pharmacist with taxonomy code 183500000X.