Provider Demographics
NPI:1720533482
Name:HUNSICKER, KEITH DOUGLAS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:DOUGLAS
Last Name:HUNSICKER
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 1:108 WOODBINE LN
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17821-9118
Mailing Address - Country:US
Mailing Address - Phone:570-214-3127
Mailing Address - Fax:
Practice Address - Street 1:108 WOODBINE LN
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17821-9118
Practice Address - Country:US
Practice Address - Phone:570-214-3127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-23
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP450814183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist