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NPI 1932071222

NPI 1932071222 : BROOKE MEGELA : POOLER, GA

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General NPI Number Information
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    NPI Number           |    1932071222
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    Entity Type          |    Individual 
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    Provider Name        |    BROOKE MEGELA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/18/2025
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    Last Update Date     |    09/28/2025
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Provider Practice Location Address
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    Address Line         |    1038 US HIGHWAY 80 W 
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    City                 |    POOLER
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    State                |    GA
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    Zip                  |    31322-2114
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    Country              |    US
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    Telephone            |    850-781-6665
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1038 US HIGHWAY 80 W 
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    City                 |    POOLER
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    State                |    GA
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    Zip                  |    31322-2114
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    Country              |    US
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    Telephone            |    850-781-6665
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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       |    RPH035849
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    License Number State |    GA
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