Provider Demographics
NPI:1518275569
Name:O'KEEFE, CECELIA ROSE (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:CECELIA
Middle Name:ROSE
Last Name:O'KEEFE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1749 W WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756-3323
Mailing Address - Country:US
Mailing Address - Phone:910-441-9842
Mailing Address - Fax:
Practice Address - Street 1:1749 W WALNUT ST
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-3323
Practice Address - Country:US
Practice Address - Phone:910-441-9842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-23
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17877183500000X
PARP038410L183500000X
ARPDP13909183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0315275Medicaid
NC380456365OtherMEDICARE