Organization
BRIAN FONTAINE KEYS
Active
Other names
COMMUNITY PROFESSIONAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN KEYES (RPH)
(951) 683-1200
Entity
Organization
Contact information
Practice address
4510 BROCKTON AVE STE 107, STE 107, RIVERSIDE, CA 92501-4020
(951) 683-1200
(951) 683-8078
Mailing address
4510 BROCKTON AVE STE 107, STE 107, RIVERSIDE, CA 92501-4020
(951) 683-1200
(951) 683-8078
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY22224
CA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2116108
PK
—
05
—
PHY22224
—
CA
Enumeration date
08/31/2006
Last updated
09/19/2025
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