Provider Demographics
NPI:1518296128
Name:KEEFE, JAMES ROSE (RPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ROSE
Last Name:KEEFE
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 1:2100 TARLETON ST
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79707-6634
Mailing Address - Country:US
Mailing Address - Phone:432-697-6320
Mailing Address - Fax:
Practice Address - Street 1:215 ANDREWS HWY
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-6331
Practice Address - Country:US
Practice Address - Phone:432-682-8211
Practice Address - Fax:432-685-0628
Is Sole Proprietor?:No
Enumeration Date:2009-12-10
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17378183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist