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KEYSTONE PHARMACY
NPI 1316049745
Pharmacy - Compounding Pharmacy in Grand Rapids, MI

Active since September 05, 2006
4021 CASCADE RD SE, GRAND RAPIDS, MI 49546(616) 974-9792(616) 464-3469 Get Directions Write a Review

NPPES record last updated: March 17, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 17, 2017, Jan 18, 2017, Jun 16, 2016 (3 updates tracked since 2016).

About Keystone Pharmacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KEYSTONE PHARMACY (NPI 1316049745) is a healthcare organization registered as a compounding pharmacy in Grand Rapids, Michigan and active in the NPI registry since September 2006. The organization lists David Miller, Owner, as its authorized official.

NPPES Registry Identity

NPI1316049745
Entity TypeOrganization
Primary Taxonomy3336C0004X
Legal Business NameKEYSTONE PHARMACY INC
Location Address4021 CASCADE RD SEGrand Rapids, MI 49546-2177
Mailing Address4021 Cascade Rd SeGrand Rapids, MI 49546-2177 · (616) 974-9792 · Fax (616) 464-3469
Phone(616) 974-9792
Fax(616) 464-3469
Organization SubpartNo
Authorized OfficialDavid MillerOwner · (616) 974-9792
Enumeration DateSeptember 5, 2006
Last NPPES UpdateMarch 17, 20173 updates tracked since enumeration
✔ NPI 1316049745 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Compounding PharmacySuppliers
Taxonomy Code3336C0004X
License✔ Licensed in MI · 5301007431
Definition
A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner's Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice.
Also ListedPharmacyTaxonomy 333600000X
Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X
4021 CASCADE RD SE, Grand Rapids, MI 49546
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Other Names 1

Doing Business AsKeystone Pharmacy

Other Identifiers 2

Other2045985Pk
Medicaid2369086MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness and more.Insurance ›

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. SUZANNE NASH ANTHONY R.PH.
Pharmacist
4021 CASCADE RD SE
GRAND RAPIDS, MI 49546
Kent County (616) 974-9792
DR. DAVID JOSEPH MILLER RPH, PHD
Pharmacist
4021 CASCADE RD SE, SUITE 50
GRAND RAPIDS, MI 49546
Kent County (616) 974-9792
KEYSTONE PHARMACY, INC.
Pharmacy (Long Term Care Pharmacy)
4021 CASCADE RD SE, SUITE 50
GRAND RAPIDS, MI 49546
Kent County (616) 974-9792
MR. THOMAS A. MAGNIFICO RPH
Pharmacist
4021 CASCADE RD SE, SUITE 50
GRAND RAPIDS, MI 49546
Kent County (616) 974-9792

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Keystone Pharmacy Inc's NPI number?

The NPI number for Keystone Pharmacy Inc is 1316049745. It was assigned to this organization in the NPPES registry on September 5, 2006. The provider is doing business as Keystone Pharmacy.

Where is Keystone Pharmacy Inc located?

Keystone Pharmacy Inc is located at 4021 Cascade Rd SE, Grand Rapids, MI 49546. The listed phone number is (616) 974-9792.

What is Keystone Pharmacy Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Compounding Pharmacy, with taxonomy code 3336C0004X.

What insurance does Keystone Pharmacy Inc accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and Ambetter from Arkansas Health & Wellness and 38 other insurers list Keystone Pharmacy Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Keystone Pharmacy Inc was last updated on March 17, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.