Healthcare Provider Details

I. General information

NPI: 1821796152
Provider Name (Legal Business Name): MEREDITH A DEAN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2023
Last Update Date: 02/16/2023
Certification Date: 08/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

436 5TH TED STEVENS WAY
KOTZEBUE AK
99752
US

IV. Provider business mailing address

PO BOX 277
KOTZEBUE AK
99752-0277
US

V. Phone/Fax

Practice location:
  • Phone: 907-442-7182
  • Fax: 907-442-7309
Mailing address:
  • Phone: 907-442-7182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberP8925
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: