MEDICARE: JEFFREY PAUL KLINE RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	03213825	OH

General Provider Information

NPI Number	:	1508469602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY PAUL KLINE RPH

Provider Business Mailing Address
First Line	:	438 MINER RD
Second Line	:
City	:	HIGHLAND HEIGHTS
State	:	OH
Zip	:	44143-1539
Country	:	US
Telephone Number	:	216-375-3374
Fax Number	:

Provider Business Practice Location Address
First Line	:	22840 LAKE SHORE BLVD
Second Line	:
City	:	EUCLID
State	:	OH
Zip	:	44123-1321
Country	:	US
Telephone Number	:	216-731-7474
Fax Number	:	216-731-1716

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/19/2020
Last Update Date	:	11/19/2020

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