Healthcare Provider Details

I. General information

NPI: 1265988414
Provider Name (Legal Business Name): BREANNA MEINZER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2016
Last Update Date: 08/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 S MAIN ST
ADA OH
45810-6000
US

IV. Provider business mailing address

2140 MILESTONE DR APT 324
FINDLAY OH
45840-7351
US

V. Phone/Fax

Practice location:
  • Phone: 734-770-3351
  • Fax:
Mailing address:
  • Phone: 734-770-3351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number03135619
License Number StateOH

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: