Organization
KEYSTONE HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID RANDOLPH (AUTHORIZED OFFICIAL)
(308) 487-5922
Entity
Organization
Contact information
Practice address
508 NIOBRARA AVE, HEMINGFORD, NE 69348-9703
(308) 487-5922
Mailing address
PO BOX 95, HEMINGFORD, NE 69348-0095
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/27/2023
Last updated
10/17/2023
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