Individual provider Active NPI

Keith Thomas Pfaff, PHARM.D.

  • Pharmacist
  • Parkton, MD
National Provider Identifier
1083996524
Registry record updated Jun 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
17405 Issued in MD
Practice address
216 Mount Carmel Rd
Parkton, MD 21120-9725
Phone
(410) 329-6209
Fax
(410) 357-8002
NPI assigned
Sep 11, 2011
Last updated
Jun 19, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 17405 MD Primary

Addresses

Primary practice location

216 Mount Carmel Rd
Parkton, MD 21120-9725

Mailing address

216 Mount Carmel Rd
Parkton, MD 21120-9725
Phone (410) 329-6209

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
17405MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Hereford Pharmacy Inc CurrentSince Nov 3, 2024 Accepting new patients
Hereford Pharmacy Inc Current Accepting new patients

Locations

216 Mount Carmel Rd
Parkton, MD 21120
Phone (410) 329-6209

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1315699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403136000000",
    "number": "1083996524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 MOUNT CARMEL RD",
            "city": "PARKTON",
            "state": "MD",
            "postal_code": "211209725",
            "telephone_number": "410-329-6209",
            "fax_number": "410-357-8002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 MOUNT CARMEL RD",
            "city": "PARKTON",
            "state": "MD",
            "postal_code": "211209725",
            "telephone_number": "410-329-6209",
            "fax_number": "410-357-8002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFAFF",
        "first_name": "KEITH",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-11",
        "last_updated": "2014-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "17405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parkton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.