Healthcare Provider Details

I. General information

NPI: 1316386196
Provider Name (Legal Business Name): MEGAN LYNN GRAVER PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2013
Last Update Date: 02/19/2024
Certification Date: 02/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 AMERICAN ST
CATASAUQUA PA
18032-1800
US

IV. Provider business mailing address

5622 WYNNEWOOD DR
LAURYS STATION PA
18059-1122
US

V. Phone/Fax

Practice location:
  • Phone: 610-264-5471
  • Fax:
Mailing address:
  • Phone: 570-706-6117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP445692
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: