Provider Demographics
NPI:1558708925
Name:KEEHN, RICK L (RPH)
Entity Type:Individual
Prefix:
First Name:RICK
Middle Name:L
Last Name:KEEHN
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 1:5080 CORUNNA RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-4199
Mailing Address - Country:US
Mailing Address - Phone:810-230-8226
Mailing Address - Fax:810-230-9856
Practice Address - Street 1:5080 CORUNNA RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-4199
Practice Address - Country:US
Practice Address - Phone:810-230-8226
Practice Address - Fax:810-230-9856
Is Sole Proprietor?:No
Enumeration Date:2013-05-26
Last Update Date:2013-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302022589183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist