Provider Demographics
NPI:1982732665
Name:KEITA, NABY M (RPH)
Entity Type:Individual
Prefix:MR
First Name:NABY
Middle Name:M
Last Name:KEITA
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 1:149 CHEEK RD
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19363-1047
Mailing Address - Country:US
Mailing Address - Phone:610-998-9788
Mailing Address - Fax:
Practice Address - Street 1:495 NORTH 3 RD STREET
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:PA
Practice Address - Zip Code:19363
Practice Address - Country:US
Practice Address - Phone:610-932-5200
Practice Address - Fax:610-932-6855
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP045020L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist