Active NPI
Keith Holley Cantrell, RPH
- Pharmacist
- Madison, AL
National Provider Identifier
1538351960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11302
- Practice address
- 8050 Highway 72 W
Madison, AL 35758-9567 - Phone
- (256) 830-1630
- Fax
- (256) 830-2206
- NPI assigned
- Aug 9, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 11302 | AL | Primary |
Addresses
Primary practice location
8050 Highway 72 W
Madison, AL 35758-9567
Mailing address
100 Thoroughbred TRL
Madison, AL 35758-6238
Phone (256) 722-4796
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 |
|---|---|---|---|
| 11302 | AL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern Family Markets LLC | 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
- Madison, AL
- NPI 1790878155
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186617600000",
"number": "1538351960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 THOROUGHBRED TRL",
"city": "MADISON",
"state": "AL",
"postal_code": "357586238",
"telephone_number": "256-722-4796",
"fax_number": "256-830-2206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8050 HIGHWAY 72 W",
"city": "MADISON",
"state": "AL",
"postal_code": "357589567",
"telephone_number": "256-830-1630",
"fax_number": "256-830-2206"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANTRELL",
"first_name": "KEITH",
"middle_name": "HOLLEY",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-09",
"last_updated": "2007-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AL",
"license": "11302",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.