Provider Demographics
NPI:1376770271
Name:KEEFE, SUSAN DIANE (PHARMACIST)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:DIANE
Last Name:KEEFE
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 HARPHEN ST
Mailing Address - Street 2:
Mailing Address - City:MCKEESPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15132-6618
Mailing Address - Country:US
Mailing Address - Phone:412-672-2826
Mailing Address - Fax:
Practice Address - Street 1:1615 LINCOLN WAY
Practice Address - Street 2:
Practice Address - City:WHITE OAK
Practice Address - State:PA
Practice Address - Zip Code:15131-1713
Practice Address - Country:US
Practice Address - Phone:412-672-5576
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-18
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP028219L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist