Provider Demographics
NPI:1851824932
Name:KING, VICKI LEIGH (RPH)
Entity Type:Individual
Prefix:MRS
First Name:VICKI
Middle Name:LEIGH
Last Name:KING
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 1:2139 AUBURN AVE
Mailing Address - Street 2:#1005
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2906
Mailing Address - Country:US
Mailing Address - Phone:513-585-0059
Mailing Address - Fax:513-585-0529
Practice Address - Street 1:2139 AUBURN AVE
Practice Address - Street 2:#1005
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2906
Practice Address - Country:US
Practice Address - Phone:513-585-0059
Practice Address - Fax:513-585-0529
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-06
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03223011183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist