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Organization

DANIEL P. KELLER

Active
Other names
MORTONS PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
DANIEL KELLER (OWNER)
(248) 651-4044
Entity
Organization

Contact information

Practice address
118 W UNIVERSITY DR, ROCHESTER, MI 48307-1987
(248) 651-4044
(248) 651-4046
Mailing address
118 W UNIVERSITY DR, ROCHESTER, MI 48307-1987
(248) 651-4044
(248) 651-4046

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301001437
MI
3336C0004X
Compounding Pharmacy
3336S0011X
Specialty Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2330140
NCPDP PROVIDER IDENTIFICATION NUMBER
05
2330140
MI
Enumeration date
08/21/2006
Last updated
02/14/2012
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