Provider Demographics
NPI:1558564120
Name:KEENAN, ANDREW (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:KEENAN
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 1:585 HERITAGE AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93619-7640
Mailing Address - Country:US
Mailing Address - Phone:559-325-0246
Mailing Address - Fax:559-226-1440
Practice Address - Street 1:755 N PEACH AVE STE B12
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-7255
Practice Address - Country:US
Practice Address - Phone:559-325-0246
Practice Address - Fax:559-226-1440
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50940183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist