Provider Demographics
NPI:1194938944
Name:KLEE, ISRAEL E (RPH)
Entity type:Individual
Prefix:MISS
First Name:ISRAEL
Middle Name:E
Last Name:KLEE
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 1:101 WOODARD RD
Mailing Address - Street 2:
Mailing Address - City:WEIRTON
Mailing Address - State:WV
Mailing Address - Zip Code:26062-2732
Mailing Address - Country:US
Mailing Address - Phone:304-723-5626
Mailing Address - Fax:
Practice Address - Street 1:3901 BRIGHTWAY ST
Practice Address - Street 2:
Practice Address - City:WEIRTON
Practice Address - State:WV
Practice Address - Zip Code:26062-4332
Practice Address - Country:US
Practice Address - Phone:304-748-8464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0002423183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist