Keith D Lyke, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

7806 Issued in CT

Practice address

183 Route 81
Killingworth, CT 06419-1480

Phone

(860) 452-4275

Fax

(860) 452-4278

NPI assigned

Mar 30, 2021

Last updated

Mar 30, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

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.

• Killingworth Family Pharmacy Inc

  • Community/Retail Pharmacy
  • Killingworth, CT
  • NPI 1386946366
  NPD Authorized official

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

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1417535691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 BRAULT HILL RD",
            "city": "HIGGANUM",
            "state": "CT",
            "postal_code": "064414442",
            "telephone_number": "860-685-1967",
            "fax_number": "860-452-4278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "183 ROUTE 81",
            "city": "KILLINGWORTH",
            "state": "CT",
            "postal_code": "064191480",
            "telephone_number": "860-452-4275",
            "fax_number": "860-452-4278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYKE",
        "first_name": "KEITH",
        "middle_name": "D",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-30",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "7806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Doyle Joyner, LMFT
• Killingworth Ambulance Association, Inc
• Killingworth Family Pharmacy Inc
• Jessie Larson, M.D.
• Rachael K. Leombruno, LMFT
• Mandy Major, PCD
• Jennifer Ann Mandeville, OTR/L
• Sharon Lynn Marczewski, M.S., CCC-SLP
• Patricia McCay, MS, CCC-SLP
• Lynn Monahan, PH.D.

• Pharmacist in Killingworth, CT
• Providers in Killingworth, CT by specialty
• Pharmacist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; 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.