Provider Demographics
NPI:1699980102
Name:KLUESNER, CHARLES PRESTON (RPH)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:PRESTON
Last Name:KLUESNER
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 1:105 STONEYBROOK DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-2270
Mailing Address - Country:US
Mailing Address - Phone:859-623-0948
Mailing Address - Fax:
Practice Address - Street 1:237 MOUNTAIN PARKWAY SPUR
Practice Address - Street 2:
Practice Address - City:CAMPTON
Practice Address - State:KY
Practice Address - Zip Code:41301
Practice Address - Country:US
Practice Address - Phone:606-668-3900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY006424183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist