Keaveny Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

263708 Issued in MN

Legal business name

KEAVENY PHARMACY INC

Practice address

205 Broadway Ave S
Cokato, MN 55321-4681

Phone

(320) 286-5483

Fax

(320) 286-6365

NPI assigned

Jan 22, 2007

Organization subpart

No

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

Authorized official

Name

Deborah Keaveny

Title

Owner

Phone

(612) 791-6687

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Keaveny Drug Doing business as

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433376000000",
    "number": "1861546509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 340",
            "city": "COKATO",
            "state": "MN",
            "postal_code": "553210340",
            "telephone_number": "320-286-5483",
            "fax_number": "320-286-6365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 BROADWAY AVE S",
            "city": "COKATO",
            "state": "MN",
            "postal_code": "553214681",
            "telephone_number": "320-286-5483",
            "fax_number": "320-286-6365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEAVENY PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2015-06-04",
        "status": "A",
        "authorized_official_last_name": "KEAVENY",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-791-6687"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MN",
            "license": "263708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "491760000",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2130706",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Keaveny Drug",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanda Hesse
• Christina Marie Hubbell, LPCC
• Independent School District No 466
• Kato Project 3
• Keaveny Pharmacy Inc
• Malinda May Kranz-Marble, LADC
• Michelle Lea Kraushaar Campbell, LMFT
• Jacqueline Ann Lasanen, LPN
• Alaina J Lund, CD(DONA)
• Kathryn Lundeen

• All providers in Cokato, MN
• Community/Retail Pharmacy in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.