1700011061 NPI number — DR. JULIE DEEANN KLEINPETER PHARM.D.

Table of content: DR. JULIE DEEANN KLEINPETER PHARM.D. (NPI 1700011061)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700011061 NPI number — DR. JULIE DEEANN KLEINPETER PHARM.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KLEINPETER
Provider First Name:
JULIE
Provider Middle Name:
DEEANN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARM.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BARGER
Provider Other First Name:
JULIE
Provider Other Middle Name:
DEEANN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1700011061
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/23/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1128 SPARKS RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEXINGTON
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40505-4018
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
KROGER PHARMACY
Provider Second Line Business Practice Location Address:
2200 INDEPENDENCE DRIVE
Provider Business Practice Location Address City Name:
GREENWOOD
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46143
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-883-4145
Provider Business Practice Location Address Fax Number:
317-883-4147
Provider Enumeration Date:
05/15/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  26023572A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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