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General NPI Number Information
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NPI Number | 1023168309
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Entity Type | Organization
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Legal Business Name | KOHLER PROFESSIONAL PHARMACY LLC
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 02/15/2008
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Provider Practice Location Address
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Address Line | 1007 ELKTON DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80907-3539
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Country | US
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Telephone | 719-473-1823
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6680
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City | LEES SUMMIT
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State | MO
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Zip | 64064-6680
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Country | US
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Telephone | 816-777-0609
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | ROBERT WINTERS
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Credential |
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Telephone | 816-777-0609
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | BK9532222
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License Number State | CO
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