Provider Demographics
NPI:1023356276
Name:KLINE, PHILIP (RPH)
Entity type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:
Last Name:KLINE
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 1:13060 ADAMS RD
Mailing Address - Street 2:
Mailing Address - City:GRANGER
Mailing Address - State:IN
Mailing Address - Zip Code:46530-8787
Mailing Address - Country:US
Mailing Address - Phone:574-243-5468
Mailing Address - Fax:574-243-5664
Practice Address - Street 1:13060 ADAMS RD
Practice Address - Street 2:
Practice Address - City:GRANGER
Practice Address - State:IN
Practice Address - Zip Code:46530-8787
Practice Address - Country:US
Practice Address - Phone:574-243-5468
Practice Address - Fax:574-243-5664
Is Sole Proprietor?:No
Enumeration Date:2013-01-23
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26014977A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist