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NPI Code Detail

MEDICARE: MS. GINA L MEADOR DPH

MEDICARE:  MS. GINA L MEADOR  DPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist9748OK

General Provider Information

NPI Number : 1275539991
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. GINA L MEADOR DPH
Provider Business Mailing Address
First Line : PO BOX 467
Second Line :
City : ELK CITY
State : OK
Zip : 73648-0467
Country : US
Telephone Number : 580-225-2121
Fax Number : 580-225-4216
Provider Business Practice Location Address
First Line : 105 N MAIN ST
Second Line :
City : ELK CITY
State : OK
Zip : 73644-4751
Country : US
Telephone Number : 580-225-2121
Fax Number : 580-225-4216
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2005
Last Update Date : 07/08/2007

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Directions to “ MS. GINA L MEADOR DPH” Practice Location

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