Provider Demographics
NPI:1154073039
Name:DAY, KEITH WILLIAM (RPH)
Entity Type:Individual
Prefix:
First Name:KEITH
Middle Name:WILLIAM
Last Name:DAY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 337
Mailing Address - Street 2:
Mailing Address - City:DASSEL
Mailing Address - State:MN
Mailing Address - Zip Code:55325-0337
Mailing Address - Country:US
Mailing Address - Phone:320-221-0251
Mailing Address - Fax:
Practice Address - Street 1:1020 HIGHWAY 15
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:MN
Practice Address - Zip Code:55350-3112
Practice Address - Country:US
Practice Address - Phone:320-587-8070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-22
Last Update Date:2022-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN114829183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist