Provider Demographics
NPI:1750814281
Name:KOHN, ABBI K
Entity Type:Individual
Prefix:
First Name:ABBI
Middle Name:K
Last Name:KOHN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 STABLEWAY RD
Mailing Address - Street 2:
Mailing Address - City:PIKE ROAD
Mailing Address - State:AL
Mailing Address - Zip Code:36064-2761
Mailing Address - Country:US
Mailing Address - Phone:334-372-4044
Mailing Address - Fax:
Practice Address - Street 1:2055 E SOUTH BLVD
Practice Address - Street 2:SUITE 107
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-2001
Practice Address - Country:US
Practice Address - Phone:334-286-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-11
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL17782183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist