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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