Provider Demographics
NPI:1255931630
Name:MORGAN, CHRISTOPHER KEITH (PHARMD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:KEITH
Last Name:MORGAN
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 1:2751 E ELLISON RD
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32347-0640
Mailing Address - Country:US
Mailing Address - Phone:850-838-6434
Mailing Address - Fax:
Practice Address - Street 1:1900 S JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:FL
Practice Address - Zip Code:32348-5615
Practice Address - Country:US
Practice Address - Phone:850-223-4189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS54992183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist