Keystone Pharmacy Inc, NPI 1316049745
Compounding Pharmacy in Grand Rapids, MI, US
NPI number: what is it?
The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...
| NPI | 1316049745 |
| NPI Entity Type | Organization |
| Provider Name |
Keystone Pharmacy Inc
Doing Business As |
| Enumeration Date | September 30, 2009 |
| Last Update Date | September 30, 2009 |
| Provider Location Address | 4021 Cascade Rd Se, Grand Rapids, MI, US |
| Provider Mailing Address | 4021 Cascade Rd Se, Grand Rapids, MI, US, 495462177 |
| Is Sole Proprietor? | No |
Organization Official
| Official Name | R.PH., PH.D. David Miller |
| Official Position | OWNER |
| Phone | 616-974-9792 |
Primary Taxonomy
| Taxonomy Code | |
| Taxonomy Name | Compounding Pharmacy |
| Classification | |
| Group | |
| License No. | 5301007431 |
| License State | MI |
| Description | A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner's Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice. |
Secondary Taxonomies
| Taxonomy Code | Group | Classification | License No. | State | Primary? |
|---|---|---|---|---|---|
| No | |||||
| No |
Other Identifiers
| Identifier | Identifier State | Identifier Issuer | Type/Code |
|---|---|---|---|
| 2045985 | PK | 01 | |
| 2369086 | MI | MEDICAID | 05 |
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