Healthcare Provider Details

I. General information

NPI: 1629988647
Provider Name (Legal Business Name): KACIE CLICK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 1988
LEBANON VA
24266-1988
US

IV. Provider business mailing address

PO BOX 1988
LEBANON VA
24266-1988
US

V. Phone/Fax

Practice location:
  • Phone: 276-889-3800
  • Fax: 276-889-0170
Mailing address:
  • Phone: 276-889-3800
  • Fax: 276-889-0170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202223876
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: