Organization
KEAVENY PHARMACY INC
Active
Other names
Keaveny Drug
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH KEAVENY (OWNER)
(612) 791-6687
Entity
Organization
Contact information
Practice address
205 BROADWAY AVE S, COKATO, MN 55321-4681
(320) 286-5483
(320) 286-6365
Mailing address
PO BOX 340, COKATO, MN 55321-0340
(320) 286-5483
(320) 286-6365
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
263708
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2130706
PK
—
05
—
491760000
—
MN
Enumeration date
01/22/2007
Last updated
06/04/2015
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