Keystone Pharmacy Inc
NPI 1316049745ActiveOrganization· Pharmacy, Compounding Pharmacy· Grand Rapids, MI
Pharmacy, Compounding Pharmacy in Grand Rapids, Michigan, registered in NPPES in September 2006. The authorized official on file is David Miller, R.PH., PH.D., Owner. Enrolled in Medicare as part b supplier - mass immunization (roster biller only).
Overview
| NPI | 1316049745 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 5, 2006 |
| Last updated in NPPES | Mar 17, 2017 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy, Compounding Pharmacy Primary | 3336C0004X | 5301007431 | MI |
| Pharmacy | 333600000X | — | — |
| Pharmacy, Community/Retail Pharmacy | 3336C0003X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Mass Immunization (Roster Biller Only) (MI) |
|---|