Healthcare Provider Details

I. General information

NPI: 1922218882
Provider Name (Legal Business Name): KEVIN A KERR RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4105 CRAWFORD AVE
NORTHERN CAMBRIA PA
15714-1341
US

IV. Provider business mailing address

201 ANN CIR
INDIANA PA
15701-6007
US

V. Phone/Fax

Practice location:
  • Phone: 814-948-6720
  • Fax:
Mailing address:
  • Phone: 724-463-0288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP037481L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: