Healthcare Provider Details

I. General information

NPI: 1770794158
Provider Name (Legal Business Name): MARTHA MEEKER R.PH.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 S DETROIT AVE
TOLEDO OH
43614-2701
US

IV. Provider business mailing address

930 S. DETROIT
TOLEDO OH
43614
US

V. Phone/Fax

Practice location:
  • Phone: 419-381-1881
  • Fax:
Mailing address:
  • Phone: 419-381-1881
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: