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Organization
KEYSTONE PHARMACY LLC
Active
Organization
KEYSTONE PHARMACY LLC
Active
Other names
Keystone Specialty Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFERY KING (CHIEF CLINICAL OFFICER)
(601) 707-9727
Entity
Organization
Contact information
Practice address
106 HIGHLAND WAY STE 206, MADISON, MS 39110-6930
(601) 707-9727
(601) 510-3846
Mailing address
106 HIGHLAND WAY, SUITE 206, MADISON, MS 39110-6929
(601) 707-9727
(601) 510-3846
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
11702
MS
3336C0004X
Compounding Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2145389
PK
—
Enumeration date
10/15/2012
Last updated
04/14/2026
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