Provider Demographics
NPI:1235328550
Name:CHRISANTHUS, KEITH ALLEN (RPH)
Entity Type:Individual
Prefix:MR
First Name:KEITH
Middle Name:ALLEN
Last Name:CHRISANTHUS
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 1:10441 PERRY HWY
Mailing Address - Street 2:SUITE #16
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-9292
Mailing Address - Country:US
Mailing Address - Phone:724-934-5439
Mailing Address - Fax:724-934-5442
Practice Address - Street 1:10441 PERRY HWY
Practice Address - Street 2:SUITE #16
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-9292
Practice Address - Country:US
Practice Address - Phone:724-934-5439
Practice Address - Fax:724-934-5442
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP439635183500000X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy