MEDICARE: MRS. ANN WILLIS KEEVER

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	5097	NC

General Provider Information

NPI Number	:	1548204381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANN WILLIS KEEVER

Provider Business Mailing Address
First Line	:	102 DOCTORS PARK
Second Line	:
City	:	LINCOLNTON
State	:	NC
Zip	:	28092-4406
Country	:	US
Telephone Number	:	704-735-9072
Fax Number	:	704-735-5972

Provider Business Practice Location Address
First Line	:	102 DOCTORS PARK
Second Line	:
City	:	LINCOLNTON
State	:	NC
Zip	:	28092-4406
Country	:	US
Telephone Number	:	704-735-9072
Fax Number	:	704-735-5972

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

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	07/08/2007

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