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General NPI Number Information
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NPI Number | 1306861919
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Entity Type | Organization
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Legal Business Name | KETY INC
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 04/28/2017
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Provider Practice Location Address
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Address Line | 3589 BRODHEAD RD
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City | MONACA
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State | PA
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Zip | 15061-3138
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Country | US
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Telephone | 724-774-2990
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Fax | 724-774-6832
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Provider Business Mailing Address
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Address Line | 8571 FOXWOOD CT
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City | POLAND
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State | OH
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Zip | 44514-4313
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Country | US
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Telephone | 330-318-3926
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Fax | 330-318-3927
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Authorized Official
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Title or Position | SVP OPERATIONS
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Name | RON MCDERMOTT
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Credential |
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Telephone | 330-318-3926
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PP415299L
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License Number State | PA
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