Active NPI
Howard Marshall Keebler III, RPH
- Pharmacist
- Emporium, PA
National Provider Identifier
1194029538
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP062285L
- Practice address
- 318 E 4TH St
Emporium, PA 15834-1514 - Phone
- (814) 486-1191
- Fax
- (814) 486-1195
- NPI assigned
- Dec 28, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP062285L | PA | Primary |
| Pharmacy | 333600000X | PP410821L | PA |
Addresses
Primary practice location
318 E 4TH St
Emporium, PA 15834-1514
Mailing address
318 E 4TH St
Emporium, PA 15834-1514
Phone (814) 486-1191
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP062285L | PA | MD | Pharmacist |
| PP410821L | PA | MD | Pharmacy |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Xavier Williams Corporation | Pharmacy | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Emporium, PA
- NPI 1023002656
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1293494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1293494400000",
"number": "1194029538",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "318 E 4TH ST",
"city": "EMPORIUM",
"state": "PA",
"postal_code": "158341514",
"telephone_number": "814-486-1191",
"fax_number": "814-486-1195"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "318 E 4TH ST",
"city": "EMPORIUM",
"state": "PA",
"postal_code": "158341514",
"telephone_number": "814-486-1191",
"fax_number": "814-486-1195"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEEBLER",
"first_name": "HOWARD",
"middle_name": "MARSHALL",
"name_prefix": "Mr.",
"name_suffix": "III",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-12-28",
"last_updated": "2010-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP062285L",
"primary": true
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "PA",
"license": "PP410821L",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Emporium, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.