Provider Demographics
NPI:1407146970
Name:KEIPER, BRANDON SCOTT (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:SCOTT
Last Name:KEIPER
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:697 ASHLEY LN
Mailing Address - Street 2:
Mailing Address - City:SUMMERSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26651-1045
Mailing Address - Country:US
Mailing Address - Phone:304-619-3518
Mailing Address - Fax:
Practice Address - Street 1:ROUTE 20 AND 55
Practice Address - Street 2:
Practice Address - City:CRAIGSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26205
Practice Address - Country:US
Practice Address - Phone:304-742-3072
Practice Address - Fax:304-742-6319
Is Sole Proprietor?:No
Enumeration Date:2011-04-18
Last Update Date:2011-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0007263183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist