Provider Demographics
NPI:1639259831
Name:ABFALL, KATHY J (RPH)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:J
Last Name:ABFALL
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 1:6100 ANGEL RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-9603
Mailing Address - Country:US
Mailing Address - Phone:740-593-8228
Mailing Address - Fax:740-597-1834
Practice Address - Street 1:2 HEALTH CENTER DR
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-2907
Practice Address - Country:US
Practice Address - Phone:740-593-4737
Practice Address - Fax:740-597-1834
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH12098183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist