Healthcare Provider Details

I. General information

NPI: 1447532460
Provider Name (Legal Business Name): KEYSTONE RURAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2011
Last Update Date: 03/19/2024
Certification Date: 03/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 5TH AVE STE 101
CHAMBERSBURG PA
17201-4224
US

IV. Provider business mailing address

830 5TH AVE SUITE 101
CHAMBERSBURG PA
17201-4224
US

V. Phone/Fax

Practice location:
  • Phone: 717-709-7977
  • Fax: 717-709-7978
Mailing address:
  • Phone: 717-217-6917
  • Fax: 717-217-6995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPP482170
License Number StatePA

VIII. Authorized Official

Name: CHARLES HILL
Title or Position: DIRECTOR OF PHARMACY SERVICES
Credential:
Phone: 717-261-4967