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General NPI Number Information
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NPI Number | 1821471053
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Entity Type | Organization
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Legal Business Name | KEY HEALTH PHARMACY LLC
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Dates
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Enumeration Date | 07/07/2015
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Last Update Date | 10/30/2015
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Provider Practice Location Address
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Address Line | 560 N ESTRELLA PKWY SUITE B9
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City | GOODYEAR
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State | AZ
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Zip | 85338-9315
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Country | US
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Telephone | 623-271-8577
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Fax | 623-322-8558
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Provider Business Mailing Address
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Address Line | 560 N ESTRELLA PKWY SUITE B9
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City | GOODYEAR
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State | AZ
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Zip | 85338-9315
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Country | US
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Telephone | 623-271-8577
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Fax | 623-322-8558
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Authorized Official
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Title or Position | PHARMACIST/OWNER
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Name | KEY LAM
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Credential | PHARM D
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Telephone | 623-308-1818
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding 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 | Y006409
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License Number State | AZ
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