Organization
KEFFELER PHARMACEUTICAL INC
Active
Other names
Myers Medical Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TIM KEFFELER (OWNER/PHARMACIST)
(707) 468-1866
Entity
Organization
Contact information
Practice address
260 HOSPITAL DR, STE 111, UKIAH, CA 95482-4568
(707) 468-1866
(707) 468-1869
Mailing address
260 HOSPITAL DR, STE 111, UKIAH, CA 95482-4568
(707) 468-1866
(707) 468-1869
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY50505
CA
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2129527
PK
—
Enumeration date
12/15/2010
Last updated
08/10/2016
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