Provider Demographics
NPI:1497326714
Name:KLINEHOFFER, LUKE AUSTIN (PHARM D)
Entity Type:Individual
Prefix:
First Name:LUKE
Middle Name:AUSTIN
Last Name:KLINEHOFFER
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:718 UNION ST
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:OH
Mailing Address - Zip Code:45810-1329
Mailing Address - Country:US
Mailing Address - Phone:740-252-2778
Mailing Address - Fax:
Practice Address - Street 1:511 W LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:OH
Practice Address - Zip Code:45810-1201
Practice Address - Country:US
Practice Address - Phone:419-772-3784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-07
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03440747183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist