MEDICARE: DR. CAITLIN KEEFE 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	022492	KY
2	183500000X	Pharmacist	03441569	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	022492	OTHER	KY	KENTUCKY PHARMACIST LICENSE
2	03441569	OTHER	OH	OHIO PHARMACIST LICENSE

General Provider Information

NPI Number	:	1316679491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAITLIN KEEFE PHARMD

Provider Business Mailing Address
First Line	:	1095 MANHATTAN BLVD APT 2305
Second Line	:
City	:	DAYTON
State	:	KY
Zip	:	41074-7523
Country	:	US
Telephone Number	:	469-693-6223
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 W CORRY ST
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45219-1901
Country	:	US
Telephone Number	:	469-693-6223
Fax Number	:

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

Provider Enumeration Date	:	06/28/2022
Last Update Date	:	06/28/2022

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