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General NPI Number Information
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NPI Number | 1659753630
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Entity Type | Individual
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Provider Name | KEITH MICHAEL MCGINNIS RPH
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Gender | Male
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Dates
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Enumeration Date | 06/25/2015
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Last Update Date | 06/25/2015
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Provider Practice Location Address
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Address Line | 301 E WASHINGTON ST
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City | LA GRANGE
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State | NC
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Zip | 28551-1834
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Country | US
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Telephone | 252-566-9595
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Fax |
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Provider Business Mailing Address
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Address Line | 101 STARBOARD DR
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City | NEW BERN
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State | NC
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Zip | 28562-8931
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Country | US
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Telephone | 252-571-0996
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 06588
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License Number State | NC
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