WESTON PAUL KEEN (NPI# 1215554910) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215554910 |
| Entity Type | Individual |
| Full Name | WESTON PAUL KEEN |
| Practice Address |
1030 Jefferson Ave Memphis TN 38104-2127 |
| Mailing Address |
880 White Rd Portland TN 37148-5040 |
| Practice Telephone | 9015238990 |
| Mailing Telephone | 6158128493 |
| Enumeration Date | 2020-06-29 |
| Last Update Date | 2020-06-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | 020699 | KY | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BIRTH DATE | 02221992 | 01 |
| Street Address |
1030 JEFFERSON AVE |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38104-2127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982697025 | Katherine Denton Sanford | Optometrist | 1030 Jefferson Ave, Mail Code 112d, Memphis, TN 38104-2127 | 2005-08-24 |
| 1528667938 | Mckenzie Bahl | Recreation Therapist | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-10-19 |
| 1427656834 | Phillip David Resuggan | Music Therapist | 1030 Jefferson Ave, Memphis, TN 38104-2193 | 2020-10-16 |
| 1962009159 | Rachel Diann Roberts | Nurse Anesthetist, Certified Registered | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-10-01 |
| 1225643018 | Melanie Warren | Nurse Practitioner | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-09-09 |
| 1942828892 | Brady Cole | Pharmacist | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-07-08 |
| 1457978595 | Mariko Thel | Pharmacist | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-07-05 |
| 1225655236 | Rebecca Fong | Pharmacist | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-06-26 |
| 1225653660 | Brandy Hollums | Pharmacist | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-06-11 |
| 1609490978 | Julie Mabry | Dietitian, Registered | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-06-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952900367 | Christy White | Recreation Therapist | 1030 Jefferson Ave (rt117), Memphis, TN 38104 | 2020-10-19 |
| 1821615873 | Altiana Carter | Optometrist | 650 New York St, Memphis, Tn 38104, Memphis, TN 38104 | 2020-06-25 |
| 1952898413 | Family To Family Adult Care Service | Chore Provider | 1331 Union Ave Suite 1028, Mempnis, TN 38104 | 2018-04-19 |
| 1326544800 | Kimberly Vestoria Mcclinton | Nurse Practitioner | 2200 Union Ave 1, Memphis, TN 38104 | 2018-04-03 |
| 1649799339 | Benjamin Duhart Jr. | Pharmacist | 1265 Union Avenue- Methodist University Hospital, Ground Floor Pharmacy Administration, Memphis, TN 38104 | 2017-09-13 |
| 1134644982 | Amy Michelle Wise | Nurse Practitioner | 1325 Eastmoreland Ave Ste 500, Memphis, TN 38104 | 2017-08-13 |
| 1316468572 | Jinger Cathey | Social Worker | 1330 Jefferson Ave, Memphis, TN 38104 | 2017-06-28 |
| 1336669183 | Charma May Kavuncu | Social Worker | 1407 Union Ave Ste 1100, Memphis, TN 38104 | 2017-06-22 |
| 1003345398 | Angelica J Dennis | Nurse Practitioner | 1265 Union, Memphis, TN 38104 | 2017-06-08 |
| 1609302546 | Cheryl Beene | Nurse Practitioner | 1211 Union Ave Ste 475, Memphis, TN 38104 | 2017-05-11 |
| Find all providers in zip 38104 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649785908 | Joys Harbor Town Pharmacy | Pharmacy | 103 Harbor Town Sq, Memphis, TN 38103-8884 | 2017-12-08 |
| 1376082123 | Bensons Pharmacy II | Pharmacy | 6005 Park Ave Ste 121b, Memphis, TN 38119-5202 | 2017-02-13 |
| 1932550134 | Dnl Pharmacy LLC | Pharmacy | 2900 Kirby Rd Ste 5, Memphis, TN 38119-8205 | 2016-06-29 |
| 1477915940 | Wal-mart Stores East Lp | Pharmacy | 6727 Raleigh Lagrange Rd, Memphis, TN 38134-7017 | 2016-03-24 |
| 1134463425 | Advantage Pharmacy LLC | Pharmacy | 2175 Business Center Dr Ste 6, Memphis, TN 38134-5628 | 2012-11-27 |
| 1053613851 | Christ Community Health Services Inc | Pharmacy | 5366 Winchester Rd, 5366 Mendenhall Mall, Memphis, TN 38115-4565 | 2010-11-30 |
| 1750533816 | Hemophilia Preferred Care of Memphis Inc | Pharmacy | 6423 Shelby View Dr Ste 104, Memphis, TN 38134 | 2008-10-21 |
| 1548480841 | Wiles Drug Store Inc | Pharmacy | 1635 Union Ave, Memphis, TN 38104 | 2007-04-27 |
| 1437216694 | Methodist Healthcare-memphis Hospitals | Pharmacy | 51 North Dunlap Street, Ground Floor, Memphis, TN 38105 | 2007-01-03 |
| 1275693566 | The Prescription Shop | Pharmacy | 2207 S Lauderdale St, Memphis, TN 38106-7503 | 2006-12-09 |
| Find all providers in MEMPHIS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.