Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jason Waggoner, RPH

Individual provider Pharmacist · NPI 1033713524

Jason Waggoner, RPH is a Pharmacist in Mattoon, Illinois. Licensed in Illinois. Registered with an NPI since 2020.

Licensed in
IL
In the registry since
2020
What do these letters mean?
RPH — Registered Pharmacist
A pharmacist licensed by a state board.

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Practice location Address checks out

1316 Charleston Ave
Mattoon, IL 61938-4016
Phone: (217) 258-2920
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pharmacist (primary) Taxonomy 183500000X · Licence 051-289951 (IL)

Record details

NPI number1033713524
Entity typeIndividual (Type 1)
GenderMale
Credentials RPH
Sole proprietorNo
NPI enumeratedNovember 24, 2020
Last updated in NPPESNovember 24, 2020
Certification dateNovember 24, 2020
Mailing address1316 Charleston Ave, Mattoon, IL 61938-4016

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