Provider Demographics
NPI:1477252419
Name:EARNEST, KEITH LEMUEL (PHARMD)
Entity Type:Individual
Prefix:
First Name:KEITH
Middle Name:LEMUEL
Last Name:EARNEST
Suffix:
Gender:M
Credentials:PHARMD
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 459
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER MILLS
Mailing Address - State:CA
Mailing Address - Zip Code:96028
Mailing Address - Country:US
Mailing Address - Phone:530-336-5511
Mailing Address - Fax:530-440-7207
Practice Address - Street 1:43563 HWY 299E,
Practice Address - Street 2:
Practice Address - City:FALL RIVER MILLS
Practice Address - State:CA
Practice Address - Zip Code:96028
Practice Address - Country:US
Practice Address - Phone:530-335-5511
Practice Address - Fax:530-440-7207
Is Sole Proprietor?:No
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH50157183500000X
AL13507183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist