Healthcare Provider Details

I. General information

NPI: 1962338137
Provider Name (Legal Business Name): ZACHARY ETHAN KEEL PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 N SPRING ST
SPARTA TN
38583-1323
US

IV. Provider business mailing address

PO BOX 753
MCMINNVILLE TN
37111-0753
US

V. Phone/Fax

Practice location:
  • Phone: 931-837-5000
  • Fax:
Mailing address:
  • Phone: 931-570-1310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number49921
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: