Provider Demographics
NPI:1235133638
Name:ARBAUGH, KIMBERLY R (RPH)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:R
Last Name:ARBAUGH
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:HC 73 BOX 1
Mailing Address - Street 2:
Mailing Address - City:SENECA ROCKS
Mailing Address - State:WV
Mailing Address - Zip Code:26884-9222
Mailing Address - Country:US
Mailing Address - Phone:304-567-2636
Mailing Address - Fax:
Practice Address - Street 1:24 N MAIN ST
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26847-1518
Practice Address - Country:US
Practice Address - Phone:304-257-1044
Practice Address - Fax:304-257-2681
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV5956183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV5956OtherLICENSE NUMBER