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General NPI Number Information
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NPI Number | 1588916704
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Entity Type | Individual
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Provider Name | ASHOK KOHLI R.PH
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Gender | Male
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Dates
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Enumeration Date | 10/11/2012
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Last Update Date | 10/11/2012
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Provider Practice Location Address
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Address Line | 200 GLYNN ISLE PARKWAY MIKE KOHLI
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City | BRUNSWICK
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State | GA
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Zip | 31525-2929
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Country | US
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Telephone | 912-261-4869
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Fax | 912-261-4879
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Provider Business Mailing Address
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Address Line | 4039 CHICORA WOOD PL
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City | JACKSONVILLE
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State | FL
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Zip | 32224-7696
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Country | US
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Telephone | 904-223-3555
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Fax | 904-992-8220
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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 | RPH025819
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License Number State | GA
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