Provider Demographics
NPI:1245353689
Name:KEYES, CARRIE M (PHARM D)
Entity type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:M
Last Name:KEYES
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 DOUBLE CHURCHES RD
Mailing Address - Street 2:APT # 550
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-2786
Mailing Address - Country:US
Mailing Address - Phone:570-470-1620
Mailing Address - Fax:706-544-3168
Practice Address - Street 1:7950 MARTIN LOOP
Practice Address - Street 2:USAMEDDAC
Practice Address - City:FORT BENNING
Practice Address - State:GA
Practice Address - Zip Code:31905-5647
Practice Address - Country:US
Practice Address - Phone:706-544-1306
Practice Address - Fax:706-544-3168
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP441421183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist