Provider Demographics
NPI:1912174558
Name:KEENE, ZACHARY DAVID (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:DAVID
Last Name:KEENE
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 1:10050 INNOVATION DR
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-4931
Mailing Address - Country:US
Mailing Address - Phone:937-914-7250
Mailing Address - Fax:
Practice Address - Street 1:10050 INNOVATION DR
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-4931
Practice Address - Country:US
Practice Address - Phone:937-914-7250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-13
Last Update Date:2017-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0146389146M00000X
OH031320301835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
No146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, Intermediate