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BRIAN FONTAINE KEYS NPI 1184736001


NPI Information

NPI: 1184736001
Provider Name: BRIAN FONTAINE KEYS

Doing Business As: COMMUNITY PROFESSIONAL PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
4510 BROCKTON AVE STE 107
STE 107
RIVERSIDE, CA
ZIP 92501
Phone: (951) 683-1200
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BRIAN FONTAINE KEYS is a community/retail pharmacy pharmacy in Riverside, CA. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. BRIAN FONTAINE KEYS NPI is 1184736001. The provider is registered as an organization entity type.
The provider Is Doing Business As Community Professional Pharmacy.

The provider's business location address is:

4510 BROCKTON AVE STE 107
STE 107
RIVERSIDE, CA
ZIP 92501-020
Phone: (951) 683-1200
Fax: (951) 683-8078

The provider's authorized official is Brian Keyes .
The authorized official title is Rph and has the following contact phone number (951) 683-1200.

The enumeration date for this NPI number is 8/31/2006 and was last updated on 7/19/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
13336C0004XPharmacyCompounding PharmacyNo
2333600000XPharmacyNo
33336C0003XPharmacyCommunity/Retail PharmacyPHY22224CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1PHY22224MEDICAIDCALIFORNIA
22116108OTHERPK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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