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General NPI Number Information
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NPI Number | 1114125010
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Entity Type | Individual
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Provider Name | ANGELA GAY KLOPP BS RPH
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Gender | Female
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Dates
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Enumeration Date | 07/03/2007
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Last Update Date | 01/21/2009
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Provider Practice Location Address
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Address Line | 1370 AIRPORT ROAD
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City | LINCOLN
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State | IL
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Zip | 62656-9790
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Country | US
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Telephone | 217-732-8115
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Fax | 217-732-8398
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Provider Business Mailing Address
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Address Line | 1370 AIRPORT RD
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City | LINCOLN
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State | IL
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Zip | 62656-5420
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Country | US
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Telephone | 217-732-5648
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 051-040810
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License Number State | IL
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