Organization
DANIEL P. KELLER
Active
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
Update your record
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