Healthcare Provider Details

I. General information

NPI: 1417573940
Provider Name (Legal Business Name): CHRISTOPHER KECK PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2020
Last Update Date: 06/20/2020
Certification Date: 06/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6918 HAMILTON AVE
CINCINNATI OH
45231-5212
US

IV. Provider business mailing address

7724 COLDBROOK LN
CINCINNATI OH
45255-4326
US

V. Phone/Fax

Practice location:
  • Phone: 513-931-1717
  • Fax: 513-931-7130
Mailing address:
  • Phone: 513-582-4318
  • Fax: 513-931-7130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03233953
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: