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NPI Code Detail

MEDICARE: MEAGAN RENEE DEASON

MEDICARE:   MEAGAN RENEE DEASON
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
1183500000XPharmacist42211TN

General Provider Information

NPI Number : 1659867463
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEAGAN RENEE DEASON
Provider Business Mailing Address
First Line : 1460 FORT CAMPBELL BLVD
Second Line :
City : CLARKSVILLE
State : TN
Zip : 37042-3553
Country : US
Telephone Number : 931-648-1134
Fax Number :
Provider Business Practice Location Address
First Line : 1460 FORT CAMPBELL BLVD
Second Line :
City : CLARKSVILLE
State : TN
Zip : 37042-3553
Country : US
Telephone Number : 931-648-1134
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/04/2018
Last Update Date : 07/04/2018

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Directions to “ MEAGAN RENEE DEASON ” Practice Location

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