Keystone Pharmacy

LBN: Keystone Pharmacy Inc
Keystone Pharmacy is an health care organization with primary practice located at 4021 Cascade Rd Se , Grand Rapids MI 49546-2177. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Compounding Pharmacy is the primary health care specialty. Keystone Pharmacy Inc can be contacted via phone (616) 974-9792, or through Miller, David via phone (616) 974-9792.

Contact Information

Primary practice address
4021 Cascade Rd Se Grand Rapids MI 49546-2177
Phone: (616) 974-9792
Fax: (616) 464-3469
Website:
Map and Directions
Authorized official contact:
Name: Miller, David R.PH., PH.D.
Phone: (616) 974-9792

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X
Suppliers / Compounding Pharmacy 3336C0004X 5301007431 Michigan

Profile Details

NPI number 1316049745
LBN Legal business name Keystone Pharmacy Inc
DBA Doing business as Keystone Pharmacy
Authorized official Miller, David R.PH., PH.D.
Entity Organization
Organization subpart 1 No
Enumeration date Sep 5th, 2006
Last updated Mar 17th, 2017 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316049745 NPPES
Other 2045985 PK
MEDICAID 2369086 PK

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