Healthcare Provider Details

I. General information

NPI: 1467020008
Provider Name (Legal Business Name): KEIA HILL PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2021
Last Update Date: 06/10/2021
Certification Date: 06/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 W 7TH ST
FREDERICK MD
21702-4102
US

IV. Provider business mailing address

1305 W 7TH ST
FREDERICK MD
21702-4102
US

V. Phone/Fax

Practice location:
  • Phone: 301-631-3828
  • Fax: 301-631-3827
Mailing address:
  • Phone: 301-631-3828
  • Fax: 301-631-3827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number23943
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: