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General NPI Number Information
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NPI Number | 1053353425
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Entity Type | Organization
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Legal Business Name | KET MEDS INC.
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Dates
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Enumeration Date | 06/12/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 2419 FAR HILLS AVE
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City | DAYTON
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State | OH
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Zip | 45419-1502
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Country | US
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Telephone | 937-293-3172
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Fax | 937-293-8539
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Provider Business Mailing Address
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Address Line | 2419 FAR HILLS AVE
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City | DAYTON
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State | OH
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Zip | 45419-1502
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Country | US
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Telephone | 937-293-3172
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Fax | 937-293-8539
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. DEBORAH LYNN COX
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Credential |
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Telephone | 937-293-3172
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 02-0943900
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License Number State | OH
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