Provider Demographics
NPI:1972088854
Name:ARBOUR, KALLI (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:KALLI
Middle Name:
Last Name:ARBOUR
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:672 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01020-5069
Mailing Address - Country:US
Mailing Address - Phone:413-593-3999
Mailing Address - Fax:
Practice Address - Street 1:672 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01020-5069
Practice Address - Country:US
Practice Address - Phone:413-593-3999
Practice Address - Fax:419-593-5939
Is Sole Proprietor?:No
Enumeration Date:2018-09-26
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0014276183500000X
MAPH237820183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist