Provider Demographics
NPI:1386735876
Name:KEEFE, GEORGE HOWARD JR (RPH)
Entity type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:HOWARD
Last Name:KEEFE
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1315 RUDDIMAN DR
Mailing Address - Street 2:
Mailing Address - City:NO MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49445-3033
Mailing Address - Country:US
Mailing Address - Phone:231-744-7533
Mailing Address - Fax:231-744-7533
Practice Address - Street 1:1900 RUDDIMAN DR
Practice Address - Street 2:
Practice Address - City:NO MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49445-3033
Practice Address - Country:US
Practice Address - Phone:231-744-4718
Practice Address - Fax:231-744-5574
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5302020260183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist