MEDICARE: DR. JOSEPH MICHAEL KEATING PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	RPH029089	GA
2	183500000X	Pharmacist	11593	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	11593	OTHER	AL	ALABAMA PHARMACY LICENSE
2	351874	OTHER		NABP
3	RPH029089	OTHER	GA	GEORGIA PHARMACY LICENSE

General Provider Information

NPI Number	:	1194313551
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH MICHAEL KEATING PHARMD

Provider Business Mailing Address
First Line	:	8415 MIDLAND SPRINGS CT
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31909-2135
Country	:	US
Telephone Number	:	334-663-9041
Fax Number	:	205-262-3767

Provider Business Practice Location Address
First Line	:	3715 US HIGHWAY 431 N
Second Line	:
City	:	PHENIX CITY
State	:	AL
Zip	:	36867-2363
Country	:	US
Telephone Number	:	334-732-2267
Fax Number	:	205-262-3767

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/01/2021
Last Update Date	:	01/01/2021

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