Keith M Keller

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Legal business name

KEITH M KELLER

Practice address

233 Anisa Dr
North, SC 29112-8002

Phone

(803) 662-9952

NPI assigned

Apr 15, 2015

Organization subpart

Yes

Parent organization

BREQUAN LOGISTICSAs reported in NPPES

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

Authorized official

Name

Mr. Keith M Keller

Title

Owner

Phone

(803) 662-9952

Specialties & licenses 1

Addresses

Other names 1

• BreQuan Logistics Doing business as

Part of

Keith M Keller

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

{
    "created_epoch": "1429056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429056000000",
    "number": "1457747529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 ANISA DR",
            "city": "NORTH",
            "state": "SC",
            "postal_code": "291128002",
            "telephone_number": "803-662-9952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 ANISA DR",
            "city": "NORTH",
            "state": "SC",
            "postal_code": "291128002",
            "telephone_number": "803-662-9952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEITH M KELLER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BREQUAN LOGISTICS",
        "enumeration_date": "2015-04-15",
        "last_updated": "2015-04-15",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-662-9952",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BreQuan Logistics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ashley Hallman, PHARMD
• Laney Mae Hallman
• Dalicia Harley
• Virginia S Harley
• Tara Hook, M.D.
• Brittany H Livingston, PHARMACIST
• Davion Livingston
• Troydenius McNeal
• Michelle Mitchum, MSCJ/L, CHW, CPT, LC
• Cassandra Jo Moore, PHD, MA, LPC, LPC/S

• Non-emergency Medical Transport (VAN) in North, SC
• Providers in North, SC by specialty
• Non-emergency Medical Transport (VAN) in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2015; 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.