Provider Demographics
NPI:1730319880
Name:KLEIN, CHARLES J (RPH)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:J
Last Name:KLEIN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1360 COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-4700
Mailing Address - Country:US
Mailing Address - Phone:717-291-9126
Mailing Address - Fax:844-411-6614
Practice Address - Street 1:1360 COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-4700
Practice Address - Country:US
Practice Address - Phone:717-291-9126
Practice Address - Fax:844-411-6614
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-23
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP439204183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist