DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. EZEKIEL KEERENG KESITILWE, PHARMD

Active Sole Proprietor

DR. EZEKIEL KEERENG KESITILWE, PHARMD is a Pharmacy healthcare provider located in LAKE HAVASU CITY, Arizona. NPI 1871001248 is currently active in the NPPES registry. Verify at CMS.

Pharmacy · LAKE HAVASU CITY, AZ

Registration Details

NPI Number
1871001248
Provider Type
Individual
Gender
Male
NPI Issued
Jan 18, 2018 (8.5648440413779 yrs)
Last Updated
Jan 18, 2018
License
S013695 (AZ)
Sole Proprietor
Yes

Practice Information

Address
1980 MCCULLOCH BLVD N
LAKE HAVASU CITY, AZ, 864030969
Browse AZ providers · Browse ZIP 86403
Phone
9288548281
Fax
9284533969
Primary Specialty
Pharmacy
333600000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.