Organization
KELLER PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIRGINIA K KELLER RPH (PHARMACIST/OWNER)
(402) 755-2216
Entity
Organization
Contact information
Practice address
101 W 3RD ST, PONCA, NE 68770
(402) 755-2216
(402) 755-4260
Mailing address
101 W 3RD ST, PO BOX 365, PONCA, NE 68770-7220
(402) 755-2216
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
8240
NE
3336C0003X
Community/Retail Pharmacy
Primary
1433
NE
3336L0003X
Long Term Care Pharmacy
1433
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
470577564
—
NE
Enumeration date
08/30/2006
Last updated
12/18/2020
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