Healthcare Provider Details

I. General information

NPI: 1477483055
Provider Name (Legal Business Name): KEITH ALLEN BARNETT III PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2026
Last Update Date: 05/23/2026
Certification Date: 05/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 MAIN ST
MANNING IA
51455-1030
US

IV. Provider business mailing address

317 MAIN ST
MANNING IA
51455-1030
US

V. Phone/Fax

Practice location:
  • Phone: 712-655-2665
  • Fax:
Mailing address:
  • Phone: 712-655-2665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number25505
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: