=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194649814
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KEITH DAVID MORRIS RPH
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/05/2026
-----------------------------------------------------
Last Update Date | 08/05/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 238 MOTHER VINEYARD RD
-----------------------------------------------------
City | MANTEO
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27954-9548
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-889-4321
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 238 MOTHER VINEYARD RD
-----------------------------------------------------
City | MANTEO
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27954-9548
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-889-4321
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1835P2201X
-----------------------------------------------------
Taxonomy Name | Ambulatory Care Pharmacist
-----------------------------------------------------
License Number | 09071
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------