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NPI Code Detail

MEDICARE: MRS. SUSAN M MEADOR R.PH

MEDICARE: MRS. SUSAN M MEADOR R.PH
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
1183500000XPharmacist5302027745MI
21835P1300XPsychiatric Pharmacist5302027745MI

General Provider Information

NPI Number : 1619975075
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SUSAN M MEADOR R.PH
Provider Business Mailing Address
First Line : 2215 FULLER RD (30)
Second Line :
City : ANN ARBOR
State : MI
Zip : 48105
Country : US
Telephone Number : 734-769-7100
Fax Number :
Provider Business Practice Location Address
First Line : 2215 FULLER RD
Second Line :
City : ANN ARBOR
State : MI
Zip : 48105-2303
Country : US
Telephone Number : 734-769-7100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2005
Last Update Date : 07/31/2007

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Directions to “ MRS. SUSAN M MEADOR R.PH” Practice Location

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