Provider Demographics
NPI:1770593592
Name:KLEIN, ROGER ALLEN (RPH)
Entity type:Individual
Prefix:MR
First Name:ROGER
Middle Name:ALLEN
Last Name:KLEIN
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 1:735 DOGWOOD TER
Mailing Address - Street 2:
Mailing Address - City:BOILING SPRINGS
Mailing Address - State:PA
Mailing Address - Zip Code:17007-9635
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1700 S LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-7529
Practice Address - Country:US
Practice Address - Phone:717-272-6621
Practice Address - Fax:717-228-6163
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP025988L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist