Provider Demographics
NPI:1548333131
Name:RAY, KIMBERLY KAHLER (RPH)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:KAHLER
Last Name:RAY
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 1:140 TWIN LAKES RD
Mailing Address - Street 2:
Mailing Address - City:TRUSSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35173-2718
Mailing Address - Country:US
Mailing Address - Phone:205-655-0543
Mailing Address - Fax:
Practice Address - Street 1:5892 TRUSSVILLE CROSSING PKWY
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-8633
Practice Address - Country:US
Practice Address - Phone:205-228-0080
Practice Address - Fax:205-228-0082
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12220183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist