Healthcare Provider Details

I. General information

NPI: 1568753234
Provider Name (Legal Business Name): CHARLES K KOBLE RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2011
Last Update Date: 04/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 CARLISLE RD
DOVER PA
17315-4603
US

IV. Provider business mailing address

2567 BERKSHIRE LN
DOVER PA
17315-4615
US

V. Phone/Fax

Practice location:
  • Phone: 717-764-9831
  • Fax:
Mailing address:
  • Phone: 717-764-9351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP-027305-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: