Provider Demographics
NPI:1407926314
Name:COVER, KALINA S (RPH)
Entity Type:Individual
Prefix:DR
First Name:KALINA
Middle Name:S
Last Name:COVER
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 1:2342 DAKOTA AVE
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95358-9781
Mailing Address - Country:US
Mailing Address - Phone:209-521-2556
Mailing Address - Fax:
Practice Address - Street 1:6331 OAKDALE RD
Practice Address - Street 2:
Practice Address - City:RIVERBANK
Practice Address - State:CA
Practice Address - Zip Code:95367-9646
Practice Address - Country:US
Practice Address - Phone:209-869-9055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50186183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist