Provider Demographics
NPI:1447851282
Name:KEEGAN, CHERYL ANN (PHARMD)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:ANN
Last Name:KEEGAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 HOLLYBUSH DR
Mailing Address - Street 2:
Mailing Address - City:GLASSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08028-2921
Mailing Address - Country:US
Mailing Address - Phone:856-392-4465
Mailing Address - Fax:
Practice Address - Street 1:600 KINGS HWY N
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-1505
Practice Address - Country:US
Practice Address - Phone:856-365-0341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02739400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist