MEDICARE: MEGAN DEAVERS PHARMD

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
1	183500000X	Pharmacist	RP0012723	WV

General Provider Information

NPI Number	:	1477213510
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN DEAVERS PHARMD

Provider Business Mailing Address
First Line	:	2 RAINBOW PLZ
Second Line	:
City	:	MANNINGTON
State	:	WV
Zip	:	26582-9054
Country	:	US
Telephone Number	:	304-986-2830
Fax Number	:	304-986-2057

Provider Business Practice Location Address
First Line	:	2 RAINBOW PLZ
Second Line	:
City	:	MANNINGTON
State	:	WV
Zip	:	26582-9054
Country	:	US
Telephone Number	:	304-986-2830
Fax Number	:	304-986-2057

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/29/2021
Last Update Date	:	12/29/2021

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Directions to “ MEGAN DEAVERS PHARMD” Practice Location

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