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General NPI Number Information
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NPI Number | 1689709263
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Entity Type | Individual
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Provider Name | JACQUELINE MAE MEIK
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Gender | Female
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6949 HIGH TECH DR SUITE 102
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City | MIDVALE
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State | UT
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Zip | 84047-3705
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Country | US
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Telephone | 801-233-6100
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Fax | 801-233-6139
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Provider Business Mailing Address
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Address Line | 6297 LAURITZEN DR
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City | WEST JORDAN
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State | UT
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Zip | 84084-1216
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Country | US
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Telephone | 801-964-5753
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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 | 153831-1701
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License Number State | UT
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