Provider Demographics
NPI:1952608275
Name:KAHLE, ANDREW DANIEL (RPH)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:DANIEL
Last Name:KAHLE
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 1:29 STATION CT
Mailing Address - Street 2:APT 305
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2950
Mailing Address - Country:US
Mailing Address - Phone:814-657-0344
Mailing Address - Fax:
Practice Address - Street 1:6057 WHITE HORSE RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29611-3842
Practice Address - Country:US
Practice Address - Phone:864-295-0243
Practice Address - Fax:864-295-1959
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-23
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12683183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist