Provider Demographics
NPI:1316679491
Name:KEEFE, CAITLIN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CAITLIN
Middle Name:
Last Name:KEEFE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1095 MANHATTAN BLVD APT 2305
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:KY
Mailing Address - Zip Code:41074-7523
Mailing Address - Country:US
Mailing Address - Phone:469-693-6223
Mailing Address - Fax:
Practice Address - Street 1:1 W CORRY ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-1901
Practice Address - Country:US
Practice Address - Phone:469-693-6223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY022492183500000X
OH03441569183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY022492OtherKENTUCKY PHARMACIST LICENSE
OH03441569OtherOHIO PHARMACIST LICENSE