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General NPI Number Information
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NPI Number | 1144603424
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Entity Type | Individual
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Provider Name | JACQUELINE MEANEY
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Gender | Female
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Dates
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Enumeration Date | 07/03/2015
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Last Update Date | 07/03/2015
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Provider Practice Location Address
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Address Line | 1601 SW ARCHER RD
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City | GAINESVILLE
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State | FL
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Zip | 32608-1135
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Country | US
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Telephone | 352-376-1611
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Fax |
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Provider Business Mailing Address
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Address Line | 10 N LAKE CIR
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City | SOUTH SALEM
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State | NY
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Zip | 10590-1013
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Country | US
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Telephone | 914-552-9166
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 060429-1
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License Number State | NY
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