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NPI Code Detail

MEDICARE: DR. KEVIN KELLER II PHARMD

MEDICARE: DR. KEVIN KELLER II 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
1183500000XPharmacist03230391OH

General Provider Information

NPI Number : 1912528423
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KEVIN KELLER II PHARMD
Provider Business Mailing Address
First Line : 3026 KILCULLEN DR
Second Line :
City : COLUMBUS
State : OH
Zip : 43221-4540
Country : US
Telephone Number : 419-450-6863
Fax Number :
Provider Business Practice Location Address
First Line : 1221 GEORGESVILLE RD
Second Line :
City : COLUMBUS
State : OH
Zip : 43228-3327
Country : US
Telephone Number : 614-275-9832
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2020
Last Update Date : 05/06/2020

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