Provider Demographics
NPI:1669720108
Name:SUBLER, KEVIN E (PD PHARMD)
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:E
Last Name:SUBLER
Suffix:
Gender:M
Credentials:PD PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O.B 605
Mailing Address - Street 2:110 E. BUTLER ST
Mailing Address - City:FORT RECOVERY
Mailing Address - State:OH
Mailing Address - Zip Code:45846-0605
Mailing Address - Country:US
Mailing Address - Phone:419-375-2323
Mailing Address - Fax:419-375-4488
Practice Address - Street 1:42 W. MAIN ST
Practice Address - Street 2:KAUP PHARMACY INC
Practice Address - City:VERSAILLES
Practice Address - State:OH
Practice Address - Zip Code:45380
Practice Address - Country:US
Practice Address - Phone:937-526-3337
Practice Address - Fax:937-526-4118
Is Sole Proprietor?:No
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRPH03131763183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist