Healthcare Provider Details

I. General information

NPI: 1467091926
Provider Name (Legal Business Name): MEREDITH MCCAULEY PUCKETT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEREDITH CHRISTINE MCCAULEY

II. Dates (important events)

Enumeration Date: 01/02/2020
Last Update Date: 12/12/2023
Certification Date: 12/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 CHILDRENS DR
COLUMBUS OH
43205-2664
US

IV. Provider business mailing address

8279 ARBOR LN
BLACKLICK OH
43004-8857
US

V. Phone/Fax

Practice location:
  • Phone: 614-722-4851
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03337772
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: