Provider Demographics
NPI:1053680710
Name:KAHLE, VICKIE ANN (RPH)
Entity Type:Individual
Prefix:
First Name:VICKIE
Middle Name:ANN
Last Name:KAHLE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2366 HARDING HWY
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45804-3426
Mailing Address - Country:US
Mailing Address - Phone:419-222-1600
Mailing Address - Fax:419-222-1885
Practice Address - Street 1:2366 HARDING HWY
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804-3426
Practice Address - Country:US
Practice Address - Phone:419-222-1600
Practice Address - Fax:419-222-1885
Is Sole Proprietor?:No
Enumeration Date:2011-12-23
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03117528183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist