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General NPI Number Information
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NPI Number | 1053322545
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Entity Type | Organization
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Legal Business Name | KOHLER HOMECARE PHARMACY, INC.
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 08/06/2019
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Provider Practice Location Address
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Address Line | 2204 PARK SPRINGS BLVD SUITE A
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City | ARLINGTON
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State | TX
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Zip | 76013-5642
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Country | US
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Telephone | 817-861-4631
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Fax | 620-508-2755
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Provider Business Mailing Address
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Address Line | 2204 PARK SPRINGS BLVD SUITE A
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City | ARLINGTON
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State | TX
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Zip | 76013-5642
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Country | US
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Telephone | 817-861-4631
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Fax | 620-508-2755
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Authorized Official
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Title or Position | PRESIDENT
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Name | PAULETTE SALVANT
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Credential | RPH
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Telephone | 817-861-4631
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 19367
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License Number State | TX
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