KEYSTONE PHARMACY – NPI #1316049745
Pharmacy
A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner's Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice.
KEYSTONE PHARMACY is a pharmacy located in GRAND RAPIDS, MI. NPPES has assigned the NPI number 1316049745 to KEYSTONE PHARMACY on September 05, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “KEYSTONE PHARMACY” is a dba name, the actual legal business name for this organization is KEYSTONE PHARMACY INC. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 3336C0004X from the Health Care Provider Taxonomy code set, which is classified as Pharmacy, specializing in Compounding Pharmacy
The NPI profile was previously updated about 9 years ago on Mar 17, 2017. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for KEYSTONE PHARMACY below.
NPI Profile for
KEYSTONE PHARMACY INC
(about 20 years ago)
GRAND RAPIDS, MI 49546-2177 Phone: (616) 974-9792 Fax: (616) 464-3469
OWNER
Phone: (616) 974-9792
Identifiers for KEYSTONE PHARMACY
Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.
| Description | Issuer | State | Identifier |
|---|---|---|---|
| OTHER | PK | 2045985 | |
| MEDICAID | MI | 2369086 |
A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.
| Taxonomy Classification / Specialization | State | License |
|---|---|---|
| 3336C0004X - Pharmacy / Compounding Pharmacy (Primary) |
MI | 5301007431 |
| 3336C0003X - Pharmacy / Community/Retail Pharmacy |
||
| 333600000X - Pharmacy |
The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.