Provider Demographics
NPI:1639651805
Name:GRAHAM, KEITH STEPHEN (RPH)
Entity Type:Individual
Prefix:MR
First Name:KEITH
Middle Name:STEPHEN
Last Name:GRAHAM
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:400 HIGHLAND AVE
Mailing Address - Street 2:GEISINGER LEWISTOWN HOSPITAL PHARMACY
Mailing Address - City:LEWISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17044
Mailing Address - Country:US
Mailing Address - Phone:717-242-7276
Mailing Address - Fax:717-242-7576
Practice Address - Street 1:400 HIGHLAND AVE
Practice Address - Street 2:GEISINGER LEWISTOWN HOSPITAL PHARMACY
Practice Address - City:LEWISTOWN
Practice Address - State:PA
Practice Address - Zip Code:17044
Practice Address - Country:US
Practice Address - Phone:717-242-7276
Practice Address - Fax:717-242-7576
Is Sole Proprietor?:No
Enumeration Date:2018-09-04
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP040180L1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist